CN105012012A - Grasping treatment device - Google Patents

Abstract

A gripping treatment device includes: a probe main body capable of transmitting ultrasonic vibrations; a probe conductive part provided at the top end of the probe main body and having a first potential when a high-frequency current is passed in; a jaw part of which Can be opened and closed relative to the probe main body; the conductive part of the jaw has a second potential different from the first potential in the state where the high-frequency current is introduced, and is arranged opposite to the conductive part of the probe in the jaw; The first electrode opposite surface, which is arranged on the outer surface of the probe conductive part, in the first state, the distance from the jaw conductive part to the probe conductive part is the first distance; the second electrode opposite surface, which is arranged on the probe conductive part On the outer surface of the outer surface, which is different from the surface opposite to the first electrode, in the second state, the distance from the conductive part of the jaw to the conductive part of the probe is a second distance smaller than the first distance; the operation input part is in the second state. Switch between state 1 and state 2.

Description

handling device

This application has an international application date of March 18, 2013 (the date of entering the Chinese national phase: September 19, 2014), an international application number of PCT/JP2013/057713 (national application number: 201380015420.0), and an invention title of "holding processing device" divisional application.

technical field

The present invention relates to a grasping treatment device for grasping a grasping object such as living tissue between the tip portion of a probe unit and a jaw, and using ultrasonic vibration, high-frequency current, etc. to treat the grasping object. A process wherein the jaw can be opened and closed relative to the tip end of the probe unit.

Background technique

Patent Document 1, Patent Document 2, and Patent Document 3 disclose a grip treatment device including: a probe unit having a first electrode portion (probe conductive portion) at its tip; and a jaw capable of Open and close with respect to the first electrode part. In each grasping treatment device, the probe unit includes a probe body for transmitting ultrasonic vibrations from the proximal direction toward the distal direction, and the ultrasonic vibrations are transmitted to the first electrode portion. In addition, a high-frequency current is transmitted to the first electrode portion of the probe unit via the probe unit. The probe unit is inserted into the sheath main body, and the probe unit is electrically insulated from the sheath main body. The jaws are attached to the top end of the sheath main body. The jaw includes: an abutting portion capable of abutting against the first electrode portion when the jaw is closed relative to the first electrode portion; and a second electrode portion abutting against the first electrode portion at the abutting portion. There is a gap between the state and the first electrode part. The abutment portion of the jaw is formed of an insulating material. In addition, a high-frequency current is transmitted to the second electrode portion via the sheath main body.

In the first treatment mode as one of the treatment modes, ultrasonic vibrations are transmitted to the first electrode unit (the tip of the probe unit) in a state where living tissues such as blood vessels are held between the first electrode unit and the jaw. department). At this time, a high-frequency current is transmitted to the first electrode portion and the second electrode portion. With the living tissue to be grasped held between the distal end of the probe unit and the jaws, the ultrasonic vibration of the probe unit generates frictional heat between the distal end of the probe unit and the living tissue. The operation of cutting and coagulation of living tissue can be simultaneously performed between the tip portion of the probe unit and the jaws by utilizing the generated frictional heat. At this time, a high-frequency current flows into the living tissue grasped between the first electrode part and the second electrode part. The high-frequency current is used to denature (reform) the biological tissue, thereby promoting the coagulation of the biological tissue. In addition, in the second treatment mode different from the first treatment mode, only the high-frequency current is transmitted to the first electrode unit and the jaw in a state where living tissues such as blood vessels are held between the first electrode unit and the jaw. 2nd electrode part. At this time, the high-frequency current flows into the living tissue grasped between the first electrode part and the second electrode part, and only the coagulation of the living tissue proceeds.

prior art literature

patent documents

Patent Document 1: Specification of US Patent Application Publication No. 2009/0270853

Patent Document 2: Specification of US Patent Application Publication No. 2009/0088668

Patent Document 3: Specification of US Patent Application Publication No. 2008/132887

Contents of the invention

The problem to be solved by the invention

In each of the grasping treatment devices in Patent Document 1, Patent Document 2, and Patent Document 3, the grasped state of the living tissue to be grasped is substantially the same in the first treatment mode and the second treatment mode. Therefore, the coagulation performance of living tissue in the second treatment mode not using ultrasonic vibration is lower than that in the first treatment mode using ultrasonic vibration. Therefore, the sealing stability of the living tissue decreases in the second treatment mode in which treatment is performed using only high-frequency current.

The present invention was made with the above problems in mind, and an object of the present invention is to provide a grasping treatment device capable of improving coagulation of living tissue and stably sealing living tissue in a treatment mode that does not use ultrasonic vibrations.

solutions to problems

In order to achieve the above object, a handling device according to a technical solution of the present invention includes:

Probe unit, which has a probe body, the probe body is extended along the length axis, and can transmit ultrasonic vibration from the direction of the base end to the direction of the top end, and the above probe body has a probe conductive part at the top end;

A sheath unit, which has a sheath body through which the probe unit penetrates and is electrically insulated from the probe unit;

The jaw is mounted on the top end of the sheath body in a manner that can be opened and closed relative to the conductive portion of the probe, and has an abutting portion formed of an insulating material. In the state where the conductive part is closed, the abutting part can be in contact with the above-mentioned probe conductive part; There is a gap between the conductive parts;

The first electrode part, which is provided in at least one of the probe conductive part between the jaw and the probe conductive part in the opening and closing direction of the jaw, is transmitted to the high frequency via the probe unit. In a current state, the first electrode portion has a first potential;

The second electrode part is provided in at least one of the jaw conductive part between the jaw and the first electrode part in the opening and closing direction of the jaw, and is transmitted through the sheath unit. In a state where a high-frequency current is applied, the second electrode portion has a second potential different in magnitude from the above-mentioned first potential; and

Inter-electrode distance changing means for making the second distance between the first electrode part and the second electrode part in the second treatment mode smaller than the first electrode part and the second electrode in the first treatment mode The first distance between parts, wherein, the first treatment mode refers to the mode in which at least the above-mentioned ultrasonic vibration is transmitted to the conductive part of the probe, and the second treatment mode refers to that only the above-mentioned high-frequency current is transmitted to the above-mentioned first electrode section and the pattern of the above-mentioned 2nd electrode section.

The effect of the invention

According to the present invention, it is possible to provide a grasping treatment device capable of improving the coagulation property of living tissue and stably sealing living tissue in a treatment mode that does not use ultrasonic vibrations.

Description of drawings

FIG. 1 is a schematic diagram showing a grasping treatment device according to a first embodiment of the present invention.

2 is a cross-sectional view schematically showing the structure of the vibrator unit according to the first embodiment.

3 is a side view schematically showing the configuration of the probe unit according to the first embodiment.

4 is a cross-sectional view schematically showing the internal structure of the handle unit according to the first embodiment.

Fig. 5 is a cross-sectional view taken along line V-V in Fig. 4 .

FIG. 6 is a schematic diagram showing an electrical connection state at the vibrator case of the first embodiment.

Fig. 7 is a schematic view partially cutaway showing the configurations of the distal end of the probe unit, the distal end of the sheath unit, and the jaw of the first embodiment in the first treatment mode.

Fig. 8 is a schematic diagram partially cutaway showing the configurations of the distal end of the probe unit, the distal end of the sheath unit, and the jaw of the first embodiment in the second treatment mode.

Fig. 9 is a side view schematically showing the jaw according to the first embodiment in a partially cutaway form.

Fig. 10 is a cross-sectional view taken along line XX in Fig. 9 .

11 is a cross-sectional view schematically showing the internal structure of the rotary operation knob of the first embodiment in the first treatment mode.

12 is a cross-sectional view schematically showing the internal structure of the rotary operation knob of the first embodiment in the second treatment mode.

Fig. 13 is a sectional view taken along line 13-13 in Fig. 7 .

Fig. 14 is a sectional view taken along line 14-14 in Fig. 8 .

Fig. 15 is a sectional view taken along line 15-15 in Fig. 4 .

16 is a cross-sectional view schematically showing the configuration of the distal end of the probe unit, the distal end of the sheath unit, and the jaw in the second treatment mode according to the first modification of the first embodiment.

17 is a cross-sectional view schematically showing the internal structure of a rotary operation knob according to a second modified example of the first embodiment in the first treatment mode.

18 is a cross-sectional view schematically showing the internal structure of a rotary operation knob according to a second modified example of the first embodiment in the second treatment mode.

19 is a cross-sectional view schematically showing the structures of the distal end of the probe unit, the distal end of the sheath unit, and the jaw according to the second embodiment of the present invention in the first treatment mode.

20 is a cross-sectional view schematically showing the structures of the distal end of the probe unit, the distal end of the sheath unit, and the jaw of the second embodiment in the second treatment mode.

21 is a cross-sectional view schematically showing the internal structure of the rotary operation knob of the second embodiment in the first treatment mode.

22 is a cross-sectional view schematically showing the internal structure of the rotary operation knob of the second embodiment in the second treatment mode.

23 is a cross-sectional view schematically showing the configuration of the distal end of the probe unit, the distal end of the sheath unit, and the jaw in a modification of the second embodiment in the second treatment mode.

24 is a cross-sectional view schematically showing the structures of the distal end portion of the probe unit and the jaw according to the third embodiment of the present invention in the first treatment mode.

25 is a cross-sectional view schematically showing the configurations of the distal end portion of the probe unit and the jaw of the third embodiment in the second treatment mode.

26 is a cross-sectional view schematically showing the internal structure of the rotary operation knob according to the third embodiment in a state in which relative rotation is restricted in the first treatment mode.

27 is a cross-sectional view schematically showing the internal structure of the rotary operation knob according to the third embodiment in a relatively rotatable state.

Fig. 28 is a sectional view taken along line 28-28 in Fig. 26 .

Fig. 29 is a sectional view taken along line 29-29 in Fig. 27 .

30 is a cross-sectional view schematically showing a connected state of the rotary operation knob, the sheath unit, and the connecting cylindrical member in the third embodiment in a state in which relative rotation is restricted in the second treatment mode.

31 is a cross-sectional view schematically showing the structure of the distal end portion of the probe unit and the jaw according to a modified example of the third embodiment in the first treatment mode.

32 is a cross-sectional view schematically showing the structure of the distal end portion of the probe unit and the jaw according to a modified example of the third embodiment in the second treatment mode.

Fig. 33 is a schematic diagram showing a handle unit according to a modified example of the first to third embodiments.

Fig. 34 is a side view schematically showing a distal end portion of a probe unit and a jaw of a reference example of the present invention in a partially cutaway manner.

Fig. 35 is a sectional view taken along line 35-35 in Fig. 34 .

Fig. 36 is a sectional view taken along line 36-36 in Fig. 34 .

Detailed ways

first embodiment

A first embodiment of the present invention will be described with reference to FIGS. 1 to 15 . FIG. 1 is a diagram showing a grasping treatment device 1 according to the present embodiment. As shown in FIG. 1 , the grip treatment device 1 has a longitudinal axis C. As shown in FIG. Here, let one of the two directions parallel to the longitudinal axis C be the distal direction (direction of arrow A1 in FIG. 1 ), and let the direction opposite to the distal direction be the proximal direction (arrow A1 in FIG. 1 ). direction of A2).

A grasping treatment device 1 as a surgical device includes a vibrator unit 2 , a probe unit 3 , a handle unit 4 , and a sheath unit 5 . The vibrator unit 2 has a vibrator case 11 . One end of the cable 6 is connected to the proximal end of the vibrator case 11 . The other end of the cable 6 is connected to a power supply unit 7 . The power supply unit 7 has an ultrasonic generation current supply unit 8 , a high-frequency current supply unit 9 , and a control unit 10 . Furthermore, a surgical operation system is constituted by the gripping treatment device 1 and the power supply unit 7 .

FIG. 2 is a diagram showing the configuration of the vibrator unit 2 . As shown in FIG. 2 , an ultrasonic vibrator 12 having a piezoelectric element for converting electric current into ultrasonic vibration is provided inside the vibrator case 11 . One ends of electrical signal lines 13A and 13B are connected to the ultrasonic vibrator 12 . The electric signal lines 13A and 13B pass through the inside of the cable 6 , and the other ends are connected to the ultrasonic wave generation current supply unit 8 of the power supply unit 7 . Ultrasonic vibrations are generated in the ultrasonic vibrator 12 by supplying an electric current from the ultrasonic generating current supply unit 8 to the ultrasonic vibrator 12 via the electrical signal lines 13A and 13B. A columnar horn 15 for amplifying the amplitude of ultrasonic vibration is connected to the distal direction side of the ultrasonic vibrator 12 .

The horn 15 is supported by the vibrator case 11 and is electrically insulated from the vibrator case 11 . In addition, a female thread portion 16 is formed at the tip end portion of the horn 15 . In addition, in addition to the electric signal lines 13A and 13B connected to the ultrasonic vibrator 12 , an electric signal line 17 is also connected, and the electric signal line 17 extends from the high-frequency current supply part 9 of the power supply unit 7 through the inside of the cable 6 . set up.

FIG. 3 is a diagram showing the configuration of the probe unit 3 . As shown in FIG. 3 , the probe unit has a columnar probe body 21 extending along the longitudinal axis C. As shown in FIG. The longitudinal axis C of the gripping treatment device 1 runs through the axial center of the probe main body 21 . An external thread portion 22 is provided at a portion on the proximal direction side of the probe main body 21 . The probe main body 21 (probe unit 3 ) is attached to the horn 15 by screwing the external thread portion 22 of the probe main body 21 into the internal thread portion 16 of the horn 15 .

By attaching the probe main body 21 to the horn 15 , the ultrasonic vibration generated by the ultrasonic vibrator 12 can be transmitted to the tip of the probe main body 21 (probe unit 3 ) via the horn 15 . That is, in the probe main body 21 , ultrasonic vibration can be transmitted from the proximal direction to the distal direction. In addition, a probe conductive portion 23 is provided at the distal end portion of the probe main body 21 (probe unit 3 ). By installing the probe body 21 on the horn 15, the high-frequency current can be transmitted from the high-frequency current supply part 9 to the probe through the electrical signal line 17, the ultrasonic vibrator 12, the horn 15, and the probe body 21 (probe unit 3). Section 23. The probe conductive part 23 can be made to function as the 1st electrode part 25 which has the 1st electric potential E1 by being transmitted with a high-frequency electric current.

As shown in FIG. 1 , the handle unit 4 has a cylindrical housing 31 extending along the longitudinal axis C. As shown in FIG. The cylindrical case 31 is formed of an insulating material. A fixed handle 32 extends from the cylindrical housing 31 in a direction inclined relative to the longitudinal axis C. As shown in FIG. The fixed handle 32 is integrally formed with the cylindrical case 31 . In addition, a movable handle 33 is rotatably attached to the cylindrical housing 31 . The movable handle 33 can be opened and closed substantially parallel to the longitudinal axis C with respect to the fixed handle 32 . The movable handle 33 is located on the distal side of the fixed handle 32 . A stopper 35 is provided on the surface of the fixed handle 32 on the front end direction side. When the movable handle 33 abuts against the stopper 35 , movement of the movable handle 33 in the closing direction relative to the fixed handle 32 is restricted.

The vibrator unit 2 is connected to the cylindrical case 31 from the proximal direction side, and the sheath unit 5 is connected to the cylindrical case 31 from the distal direction side. In addition, the probe unit 3 is inserted into the cylindrical housing 31 from the distal direction side. The sheath unit 5 has a cylindrical sheath body 41 through which the probe unit 3 penetrates. A jaw 42 is rotatably attached to a distal end portion of the sheath main body 41 . The jaw 42 can be opened and closed with respect to the probe conductive part 23 (first electrode part 25 ) of the probe main body 21 .

In addition, the handle unit 4 has a rotation operation knob 37 as a rotation operation input unit connected to the distal end direction side of the cylindrical housing 31 . The rotary operation knob 37 is coupled to the cylindrical housing 31 so as to be rotatable in a direction around the longitudinal axis relative to the cylindrical housing 31 . By rotating the rotation operation knob 37 relative to the cylindrical case 31 , the vibrator unit 2 , the probe unit 3 , the sheath unit 5 , and the jaw 42 are rotated relative to the cylindrical case 31 in directions around the longitudinal axis.

FIG. 4 is a diagram showing an internal configuration of the handle unit 4 . As shown in FIG. 4 , the probe main body 21 (probe unit 3 ) and the sheath main body 41 (sheath unit 5 ) are provided extending along the longitudinal axis C to the inside of the cylindrical case 31 via the inside of the rotating operation knob 37 . Inside the cylindrical case 31 , the proximal end of the probe main body 21 is attached to the horn 15 . Thus, the vibrator unit 2 and the probe unit 3 are connected. In addition, inside the cylindrical case 31 , the base end portion of the sheath main body 41 is connected to the vibrator case 11 . Thus, the vibrator unit 2 and the sheath unit 5 are connected.

A connecting cylindrical member 45 for connecting the probe body 21 and the sheath body 41 is provided inside the cylindrical case 31 of the handle unit 4 . In addition, the sheath main body 41 has a movable cylindrical member 46 provided on the outer peripheral direction side of the connecting cylindrical member 45 . The connecting cylindrical member 45 and the movable cylindrical member 46 are arranged along the longitudinal axis C. As shown in FIG. The connecting cylindrical member 45 is formed of an insulating material such as resin. The movable cylindrical member 46 is formed of a conductive material such as metal.

Fig. 5 is a cross-sectional view taken along line V-V in Fig. 4 . As shown in FIGS. 4 and 5 , the engaging pins 47A, 47B are fixed to the rotary operation knob 37 in a state separated from each other in the direction around the longitudinal axis. The engaging pins 47A and 47B protrude in the inner peripheral direction from the inner peripheral portion of the rotary operation knob 37 . The through-holes 48A, 48B are provided in the movable cylindrical member 46 in a state of being separated from each other in the direction around the longitudinal axis. Each of the through holes 48A, 48B is formed in a long hole shape along the longitudinal axis C, and penetrates the movable cylindrical member 46 in the radial direction. Moreover, engaging recessed part 49A, 49B which dented in the inner peripheral direction is provided in the connection cylindrical member 45. As shown in FIG. The engaging recesses 49A, 49B are provided in a state of being separated from each other in the direction around the longitudinal axis.

The engaging pin 47A penetrates through the through hole 48A, and engages with the engaging recessed portion 49A. In addition, the engaging pin 47B passes through the through hole 48B, and engages with the engaging recessed portion 49B. The connecting cylindrical member 45 is fixed to the rotary operation knob 37 by engaging the respective engaging pins 47A, 47B with the corresponding engaging recesses 49A, 49B. Furthermore, by passing the respective engaging pins 47A, 47B through their respective corresponding through holes 48A, 48B, the movable cylindrical member 46 and the rotational operation knob 37 are restricted so as not to be able to rotate relative to each other in the direction around the longitudinal axis. state. However, since the through holes 48A, 48B are formed in the shape of long holes along the longitudinal axis C, the movable cylindrical member 46 can move along the longitudinal axis C with respect to the rotary operation knob 37 and the connection cylindrical member 45 . With the configuration as described above, the connecting cylindrical member 45 and the movable cylindrical member 46 can be rotated in a direction around the longitudinal axis with respect to the cylindrical housing 31 integrally with the rotation operation knob 37 . Also, the movable cylindrical member 46 is movable along the longitudinal axis C relative to the probe main body 21 (probe unit 3 ) and the handle unit 4 .

An elastic member 51 made of an insulating material is fixed to the outer peripheral portion of the proximal end portion of the probe body 21 (see FIG. 3 ). In the state where the probe body 21 is connected to the horn 15 , the elastic member 51 is located at a node position of ultrasonic vibration. The elastic member 51 is pressed in the inner peripheral direction by the inner peripheral portion of the connecting cylindrical member 45 to shrink. When the elastic member 51 contracts, the probe main body 21 (probe unit 3 ) is fixed to the connecting cylindrical member 45 . Thereby, the probe main body 21 (probe unit 3 ) and the sheath main body 41 (sheath unit 5 ) can be connected by the connection cylindrical member 45 and the elastic member 51 .

When the rotary operation knob 37 is rotated in a direction around the longitudinal axis, the rotational driving force from the rotary operation knob 37 can be transmitted to the probe main body 21 (probe unit 3 ) via the connection cylindrical member 45 and the elastic member 51 . Thus, the probe unit 3 is rotatable relative to the cylindrical housing 31 integrally with the rotary operation knob 37 and the connection cylindrical member 45 . Furthermore, since the connecting cylindrical member 45 and the elastic member 51 are formed of an insulating material, the probe main body 21 (probe unit 3 ) and the movable cylindrical member 46 are electrically insulated.

As shown in FIG. 4 , at the connecting portion between the sheath body 41 (sheath unit 5 ) and the vibrator case 11 (the vibrator unit 2 ), with the movable cylindrical member 46 inserted into the vibrator case 11 , The movable cylindrical member 46 is engaged with the vibrator case 11 . Rotation between the movable cylindrical member 46 and the vibrator case 11 relative to each other in the direction about the longitudinal axis is restricted. However, the movable cylindrical member 46 is movable along the longitudinal axis C relative to the vibrator case 11 .

In addition, an electrical connection ring 53 is provided on the outer peripheral direction side of the vibrator case 11 at the connecting portion between the sheath main body 41 and the vibrator case 11 . The electrical connection ring 53 is provided in a state of being fixed to the cylindrical case 31 of the handle unit 4 . In the state where the vibrator case 11 is connected to the sheath main body 41 (the movable cylindrical member 46 ), the outer peripheral portion of the distal end of the vibrator case 11 is in contact with the electrical connection ring 53 , and the inner peripheral portion of the distal end of the vibrator case 11 is in contact with the electrical connection ring 53 . The movable cylindrical member 46 is in contact. Furthermore, the vibrator case 11 and the sheath main body 41 are integrally rotatable in directions around the longitudinal axis with respect to the electrical connection ring 53 .

A switch arrangement portion 55 is provided between the cylindrical case 31 and the fixed handle 32 . The switch arrangement portion 55 is integrally formed with the cylindrical case 31 and the fixed handle 32 . The switch arrangement portion 55 has a planar portion 56 substantially perpendicular to the longitudinal axis C. As shown in FIG. The flat portion 56 is provided on the side where the fixed handle 32 and the movable handle 33 are located, centered on the longitudinal axis C. As shown in FIG. In addition, the planar portion 56 is located on the distal direction side of the movable handle 33 .

Processing mode input buttons 57A and 57B are provided on the flat surface portion 56 as processing mode input portions. By pressing each treatment mode input button 57A, 57B, an input operation of the treatment mode selected by the operator is performed. A switch portion 58A, a switch portion 58B, and a circuit board 59 are provided inside the switch arrangement portion 55 . The open/close state of the switch unit 58A can be switched by an input operation using the processing mode input button 57A. Similarly, the open/closed state of the switch unit 58B can be switched by an input operation using the processing mode input button 57B.

FIG. 6 is a diagram schematically showing an electrical connection state at the vibrator case 11 . As shown in FIGS. 4 and 6 , three electrical signal lines 61A to 61C are provided inside the cylindrical case 31 . The electric signal line 61A is electrically connected to the switch unit 58A via a circuit on the circuit board 59 . The electric signal line 61B is electrically connected to the switch unit 58B via a circuit on the circuit board 59 . The electrical signal line 61C is electrically connected to the switch section 58A and the switch section 58B via a circuit on the circuit board 59 . The electric signal line 61C is a common line shared as a ground line of the switch unit 58A and the switch unit 58B.

The electrical connection ring 53 has a first electrical connection portion 62A, a second electrical connection portion 62B, and a third electrical connection portion 62C. The electrical insulation between the first electrical connection portion 62A and the second electrical connection portion 62B, the electrical insulation between the second electrical connection portion 62B and the third electrical connection portion 62C, and the electrical insulation between the first electrical connection portion 62A and the third electrical connection portion 62C. Electrical insulation between. The electrical signal line 61A is connected to the first electrical connection portion 62A. The electric signal line 61B is connected to the second electric connection portion 62B. The electrical signal line 61C is connected to the third electrical connection portion 62C.

In addition, the vibrator case 11 has a first conductive portion 63A, a second conductive portion 63B, and a third conductive portion 63C. The first conductive portion 63A, the second conductive portion 63B, and the third conductive portion 63C extend along the longitudinal axis C. As shown in FIG. The first conductive portion 63A is electrically insulated from the second conductive portion 63B, the second conductive portion 63B is electrically isolated from the third conductive portion 63C, and the first conductive portion 63A is electrically isolated from the third conductive portion 63C. When the vibrator case 11 is connected to the movable cylindrical member 46 (the sheath body 41 ), only the distal end portion of the first conductive portion 63A is in electrical contact with the first electrical connection portion 62A of the electrical connection ring 53 . Likewise, only the distal end portion of the second conductive portion 63B is in electrical contact with the second electrical connection portion 62B of the electrical connection ring 53 . Furthermore, only the distal end portion of the third conductive portion 63C is in electrical contact with the third electrical connection portion 62C of the electrical connection ring 53 .

One end of an electric signal line 65 is connected to a base end portion of the first conductive portion 63A. One end of an electric signal line 66 is connected to a base end portion of the second conductive portion 63B. One end of an electric signal line 67 is connected to a base end portion of the third conductive portion 63C. The other ends of the electric signal lines 65 to 67 are connected to the control unit 10 of the power supply unit 7 after passing through the inside of the cable 6 .

As described above, the first electrical signal path is formed from the switch section 58A to the control section 10 of the power supply unit 7 via the electrical signal line 61A, the first electrical connection section 62A, the first conductive section 63A, and the electrical signal line 65 . In addition, a second electrical signal path is formed from the switch section 58B to the control section 10 of the power supply unit 7 via the electrical signal line 61B, the second electrical connection section 62B, the second conductive section 63B, and the electrical signal line 66 . In addition, a ground path is formed from the switch part 58A and the switch part 58B to the control part 10 via the electric signal line 61C, the third electric connection part 62C, the third conductive part 63C, and the electric signal line 67 .

When the processing mode input button 57A is pressed, the switch portion 58A is in a closed state, and the switch portion 58A electrically connects the first electrical signal path and the ground path. Accordingly, an electric signal is transmitted from the switch unit 58A to the control unit 10 of the power supply unit 7 . Next, an ultrasonic generating current is output from the ultrasonic generating current supply unit 8 , and a high-frequency current is output from the high-frequency current supply unit 9 . That is, the first treatment mode can be selected by pressing the treatment mode input button 57A.

Then, by pressing the processing mode input button 57B, the switch part 58B is in the closed state, and the second electrical signal path and the ground path are electrically connected by the switch part 58B. Accordingly, an electric signal is transmitted from the switch unit 58B to the control unit 10 of the power supply unit 7 . Next, a high-frequency current is output from the high-frequency current supply unit 9 . At this time, the ultrasonic generating current is not output from the ultrasonic generating current supply unit 8 . That is, the second treatment mode different from the first treatment mode can be selected by pressing the treatment mode input button 57B.

As shown in FIG. 6 , the vibrator case 11 has a fourth conductive portion 63D extending along the longitudinal axis C. As shown in FIG. All of the first conductive portion 63A, the second conductive portion 63B, and the third conductive portion 63C are electrically insulated from the fourth conductive portion 63D. An electric signal line 69 extending from the high-frequency current supply portion 9 of the power supply unit 7 via the inside of the cable 6 is connected to the base end portion of the fourth conductive portion 63D. In the state where the vibrator case 11 is connected to the movable cylindrical member 46 (sheath main body 41 ), only the distal end portion of the fourth conductive portion 63D is in electrical contact with the movable cylindrical member 46 . In this way, a high-frequency current is transmitted between the high-frequency current supply unit 9 and the movable cylindrical member 46 of the sheath body 41 via the electric signal line 69 and the fourth conductive portion 63D.

As shown in FIG. 4 , the sheath main body 41 has a fixed cylindrical member 71 located on the inner peripheral direction side of the rotary operation knob 37 . The fixed cylindrical member 71 is fixed to the rotary operation knob 37 and is formed of an insulating material such as resin. A base end portion of an outer tube (Japanese: outer tube) 72 and an outer tube (Japanese: pipe) 73 are fixed to a distal end portion of the fixed cylindrical member 71 . The outer sleeve 72 is located on the outer peripheral side of the outer tube 73 , and the outer sleeve 72 forms a package for the sheath main body 41 (the sheath unit 5 ). The outer sleeve 72 is formed of an insulating material such as resin. An inner sleeve (Japanese: inner tube) 75 is provided on the inner circumferential side of the outer tube 73 . The inner sleeve 75 is formed of an insulating material such as resin, and is fixed to the outer tube 73 via fixing pins 76A and 76B. With the above configuration, the rotary operation knob 37 can be rotated integrally with the outer sleeve 72 , the outer tube 73 , and the inner sleeve 75 relative to the cylindrical housing 31 in a direction around the longitudinal axis.

The sheath main body 41 has an inner tube 77 provided radially between the outer tube 73 and the inner sleeve 75 . The inner tube 77 is fixed to the distal end portion of the movable cylindrical member 46 via a connecting member 78 and a connecting pin 79 . The inner tube 77 is movable along the longitudinal axis C integrally with the movable cylindrical member 46 relative to the outer sleeve 72 , the outer tube 73 , and the inner sleeve 75 . That is, the inner tube 77 is movable along the longitudinal axis C integrally with the movable cylindrical member 46 relative to the handle unit 4 and the probe unit 3 .

Furthermore, since the inner tube 77 is fixed to the movable cylindrical member 46 , the rotational movement of the rotary operation knob 37 is transmitted to the inner tube 77 via the movable cylindrical member 46 . Therefore, the inner tube 77 can rotate integrally with the rotation operation knob 37 in the direction around the longitudinal axis with respect to the cylindrical housing 31 . As described above, the rotary operation knob 37 is integrally rotatable with the outer sleeve 72 , the outer tube 73 , and the inner sleeve 75 relative to the cylindrical housing 31 in the direction around the longitudinal axis. Accordingly, the sheath main body 41 is rotatable in a direction around the longitudinal axis relative to the cylindrical housing 31 integrally with the rotation operation knob 37 . Furthermore, the inner pipe 77 is formed of a conductive material such as metal. A high-frequency current is transmitted between the movable cylindrical member 46 and the inner tube 77 via the connection member 78 and the connection pin 79 .

As shown in FIG. 4 , the sheath unit 5 has a movable plate 81 as a movable portion provided on the inner peripheral direction side of the inner sleeve 75 along the longitudinal axis C. As shown in FIG. The movable plate 81 penetrates the inside of the sheath main body 41 (inner sleeve 75 ), and is formed of a conductive material such as metal. The movable plate 81 is movable along the longitudinal axis C relative to the probe main body 21 (probe unit 3 ) and the sheath main body 41 . The movable plate 81 is fixed to a movement operation lever 83 as a movement operation input part via a relay part 82 formed of a conductive material. The movement operation lever 83 is formed of an insulating material. The movement operation lever 83 is connected to the rotation operation knob 37 so that it can move along the longitudinal axis C relative to the rotation operation knob 37 . By moving the movement operation lever 83 relative to the rotation operation knob 37 , the movable plate 81 moves along the longitudinal axis C relative to the probe body 21 and the sheath body 41 . That is, an operation to move the movable plate 81 as a movable portion along the longitudinal axis C can be input using the movement operation lever 83 .

In addition, the movement operation lever 83 and the rotation operation knob 37 are connected in a state in which they cannot rotate in directions around the longitudinal axis with respect to the opposing direction. Therefore, the movement operation lever 83 and the movable plate 81 are integrally rotatable with the rotation operation knob 37 relative to the cylindrical housing 31 in the direction around the longitudinal axis. As described above, the sheath body 41 is integrally rotatable with the rotation operation knob 37 relative to the cylindrical housing 31 in the direction around the longitudinal axis. Therefore, the sheath unit 5 (the sheath main body 41 and the movable plate 81 ) can be rotated in a direction around the longitudinal axis relative to the cylindrical housing 31 integrally with the rotation operation knob 37 .

7 and 8 are diagrams showing the distal end of the probe unit 3 , the distal end of the sheath unit 5 , and the jaw 42 . Here, FIG. 7 shows a state in which the living tissue T is grasped and treated in the first treatment mode, and FIG. 8 shows a state in which the living tissue T is grasped and treated in the second treatment mode. As shown in FIGS. 7 and 8 , the outer sleeve 72 , outer tube 73 , inner sleeve 75 , and inner tube 77 extend along the longitudinal axis C to the top end of the sheath body 41 (sheath unit 5 ). As shown in FIG. 3 , a plurality of support members 85 made of an insulating material are formed on the outer peripheral portion of the probe body 21 . Each support member 85 is arranged so as to be separated from other support members 85 in a direction parallel to the longitudinal axis C. As shown in FIG. In the state where the probe main body 21 is connected to the horn 15 , each support member 85 is positioned at a node position of ultrasonic vibration.

Contact between the movable plate 81 and the probe main body 21 (probe unit 3 ) is prevented by the supporting member 85 . Furthermore, contact between the inner sheath 75 (sheath main body 41 ) and the probe main body 21 (probe unit 3 ) is prevented by the support member 85 . As described above, since the connecting cylindrical member 45 and the elastic member 51 are formed of an insulating material, the probe main body 21 (probe unit 3 ) and the movable cylindrical member 46 (sheath main body 41 ) are electrically insulated. Therefore, the sheath unit 5 (the sheath body 41 and the movable plate 81 ) and the probe unit 3 (the probe body 21 ) are electrically insulated by the connection cylindrical member 45 , the elastic member 51 , and the support member 85 .

As shown in FIGS. 7 and 8 , the jaw 42 is attached to the distal end of the sheath body 41 (the distal end of the outer sheath 72 and the outer tube 73 ) via a connecting screw 87 . The jaw 42 is rotatable about the connecting screw 87 relative to the sheath main body 41 . In addition, the distal end portion of the inner tube 77 is connected to the jaw 42 via a connecting pin 89 . A high-frequency current is transmitted between the inner tube 77 and the jaw 42 via the connection pin 89 . In this way, a high-frequency current can be transmitted from the high-frequency current supply part 9 to the jaw 42 via the electric signal line 69 , the fourth conductive part 63D, the movable cylindrical member 46 , and the inner tube 77 . FIG. 9 is a diagram showing the structure of the jaw 42 , and FIG. 10 is a cross-sectional view taken along line XX in FIG. 9 . In addition, in FIG. 10, the probe main body 21 (probe conductive part 23) is also shown together.

As shown in FIGS. 9 and 10 , the jaw 42 has a jaw body 91 attached to the sheath body 41 . The jaw body 91 is formed of a conductive material. A jaw conductive portion 93 is connected to the jaw main body 91 via a connection pin 92 . The high-frequency current transmitted from the inner tube 77 of the sheath body 41 to the jaw 42 is transmitted to the jaw conductive portion 93 via the jaw body 91 . By transmitting high-frequency current to the jaw conductive portion 93 via the sheath main body 41 (sheath unit 5 ), the jaw conductive portion 93 can have a second potential E2 different in magnitude from the first potential E1 .

A pad member 95 formed of an insulating material and serving as an insulating contact member is attached to the jaw conductive portion 93 . The pad member 95 has a jaw vertically opposing surface (contact portion) 97 perpendicular to the opening and closing direction of the jaw 42 . Furthermore, in the direction perpendicular to the longitudinal axis C and to the opening and closing direction of the jaw 42 , that is, in the width direction, on both sides of the jaw vertically facing surface 97 , the jaw conductive portion 93 forms jaw obliquely facing surfaces 98A. , 98B. In a section perpendicular to the longitudinal axis C, the jaw obliquely facing faces 98A, 98B are inclined relative to the jaw vertically facing face 97 .

On the other hand, as shown in FIG. 10 , the probe conductive portion 23 (first electrode portion 25 ) has a probe vertically facing surface 102 perpendicular to the opening and closing direction of the jaw 42 . The probe vertically opposite surface 102 is substantially parallel to the jaw vertically opposite surface 97 and is opposite to the jaw vertically opposite surface 97 . Moreover, when there is no grasping object such as a blood vessel (biological tissue) between the probe conductive part 23 (first electrode part 25) and the jaw 42, and the movement operation lever 83 is positioned at the first operation position as described later, In the position state, when the jaw 42 is closed relative to the probe conductive part 23 , the jaw vertically facing surface 97 abuts the probe vertically facing surface 102 of the probe conductive part 23 . That is, in a state where the jaw 42 is closed with respect to the probe conductive part 23 , the jaw vertically facing surface (abutting part) 97 can come into contact with the probe conductive part 23 .

In addition, on both sides of the probe vertically facing surface 102, in the direction perpendicular to the longitudinal axis C and perpendicular to the opening and closing direction of the jaw 42, that is, in the width direction, a probe is formed by the probe conductive part 23 (first electrode part 25). The opposing surfaces 103A, 103B are inclined. The probe obliquely facing surface 103A is approximately parallel to the jaw obliquely opposing surface 98A, and the probe obliquely opposing surface 103B is approximately parallel to the jaw obliquely opposing surface 98B. Moreover, when there is no grasping object such as a blood vessel (biological tissue) between the probe conductive part 23 (first electrode part 25) and the jaw 42, and the movement operation lever 83 is positioned at the first operation position as described later, position, when the jaw 42 is closed relative to the probe conductive part 23, a gap is always formed between the probe inclined facing surface 103A and the jaw inclined facing surface 98A, and the probe inclined facing surface 103B and the jaw inclined facing surface A gap is always formed between 98B. That is, the jaw 42 is closed relative to the probe conductive part 23 in the state where there is no grasping object such as a blood vessel (biological tissue), and the jaw vertically facing surface (abutting part) 97 is aligned with the probe conductive part 23 (the probe is perpendicular to each other). When the opposing surfaces 102) are in contact with each other, there is a gap between the jaw conductive part 93 and the probe conductive part 23 (first electrode part 25).

11 and 12 are diagrams showing the internal structure of the rotary operation knob 37 . FIG. 11 shows the first processing mode, and FIG. 12 shows the second processing mode. In addition, FIG. 13 is a sectional view taken along line 13 - 13 in FIG. 7 , and FIG. 14 is a sectional view taken along line 14 - 14 in FIG. 8 . As shown in FIG. 11 , in the first treatment mode, the movement operation lever 83 is located at the first operation position. At this time, the movable plate 81 and the relay portion 82 are not in contact with the inner tube 77 . Therefore, the movable plate 81 is electrically insulated from the inner tube 77 , and high-frequency current is not transmitted to the movable plate 81 .

A moving conductive portion 101 is provided at the tip end portion of the movable plate 81 . In the first treatment mode, as shown in FIG. 7 , the moving conductive part 101 is housed inside the sheath main body 41 by the operation of moving the moving operation lever 83 to the first operating position. That is, the moving conductive portion 101 is located on the proximal direction side of the jaw 42 .

In addition, in the first treatment mode, an ultrasonic generating current is output from the ultrasonic generating current supply unit 8 . Therefore, ultrasonic vibration is generated by the ultrasonic vibrator 12, and the ultrasonic vibration is transmitted to the probe conductive portion 23 (the tip portion of the probe unit 3). In addition, in the first treatment mode, a high-frequency current is output from the high-frequency current supply unit 9 . Therefore, the high-frequency current is transmitted to the probe conductive part 23, and the probe conductive part 23 becomes the first electrode part 25 having the first potential E1. In addition, the high-frequency current is transmitted to the jaw conductive portion 93 of the jaw 42, so that the jaw conductive portion 93 has the second potential E2. At this time, since the high-frequency current is not transmitted to the movable plate 81, the moving conductive portion 101 does not function as an electrode.

Therefore, in the first treatment mode, only the jaw conductive part 93 functions as the second electrode part 105 having the second potential E2. In the first treatment mode, in the state of holding the living tissue T, the first electrode part 25 (the probe obliquely facing surfaces 103A, 103B) and the jaw conductive part 93 (the jaw obliquely facing each other) of the second electrode part 105 The distance between the surfaces 98A, 98B) is the first distance D1. That is, in the first treatment mode, the high-frequency treatment is performed on the living tissue T in a state having the first distance D1.

As shown in FIG. 12 , in the second treatment mode, the movement operation lever 83 is moved to the distal direction side from the first operation position to be located at the second operation position. At this time, the relay portion 82 is in contact with the inner tube 77 . Accordingly, the movable plate 81 is electrically connected to the inner tube 77 , and high-frequency current is transmitted to the movable plate 81 . When the high-frequency current is transmitted to the movable plate 81, the moving conductive part 101 has the second potential E2.

As shown in FIGS. 8 and 14 , in the second treatment mode, through the operation of moving the operating lever 83 to the second operating position, the moving conductive part 101 is located on the vertically opposite surface 97 of the jaw in the direction of opening and closing of the jaw 42 . (jaw part 42 ) and probe vertically facing surface 102 (first electrode part 25 ). The moving conductive part 101 has a movable part facing surface 106 perpendicular to the opening and closing direction of the jaw 42 . In the second treatment mode in which the movement operation lever 83 is located at the second operation position, the movable part facing surface 106 is substantially parallel to the probe vertically facing surface 102 and faces the probe vertically facing surface 102 . Here, the distance between the movable part facing surface 106 (movable conductive part 101 ) and the probe vertical facing surface 102 (first electrode part 25 ) in the state of holding the living tissue T is smaller than the first distance D1. The second distance D2.

In the second treatment mode, the ultrasonic generating current is not output from the ultrasonic generating current supply unit 8 , and only the high frequency current is output from the high frequency current supply unit 9 . Therefore, the ultrasonic vibrator 12 does not generate ultrasonic vibrations. In addition, the high-frequency current is transmitted to the probe conductive part 23, and the probe conductive part 23 functions as the first electrode part 25 having the first potential E1. In addition, the high-frequency current is transmitted to the jaw conductive portion 93 of the jaw 42, and the jaw conductive portion 93 has the second potential E2. At this time, since the high-frequency current is transmitted to the movable plate (movable part) 81, the moving conductive part 101 also has the second potential E2.

Therefore, in the second treatment mode, the jaw conductive part 93 and the moving conductive part 101 function as the second electrode part 105 having the second potential E2, and the moving conductive part 101 becomes a part of the second electrode part 105 . Therefore, in the second treatment mode, in the state of holding the living tissue T, the first electrode part 25 (probe vertically facing surface 102) and the moving conductive part 101 (movable part facing surface) of the second electrode part 105 106) The distance between them is the second distance D2 which is smaller than the first distance D1. That is, in the second treatment mode, the high-frequency treatment can be performed on the living tissue T with the second distance D2 smaller than the first distance D1. As described above, the moving operation lever (moving operation input unit) 83 becomes the inter-electrode distance changing unit capable of making the second distance D2 smaller than the first distance D1, wherein the first distance D1 refers to the first distance in the first treatment mode. The distance between the electrode part 25 and the second electrode part 105, the second distance D2 refers to the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode. That is, the distance between the two electrode parts (the first electrode part 25 and the second electrode part 105 ) is changed by moving the operation lever 83 . In addition, in the second treatment mode, ultrasonic vibration is not transmitted to the probe conductive part 23 (tip part of the probe unit 3 ), but only high-frequency current is transmitted to the first electrode part 25 and the second electrode part 105 . In the second treatment mode, by reducing the distance between the first electrode unit 25 and the second electrode unit 105 , sufficient high-frequency treatment (for example, coagulation of the living tissue T) can be performed on the living tissue T.

Fig. 15 is a sectional view taken along line 15-15 in Fig. 4 . As shown in FIGS. 4 and 15 , the movable handle 33 is attached to the cylindrical case 31 via a fulcrum pin 111 . The movable handle 33 rotates around the fulcrum pin 111 relative to the cylindrical housing 31 . In addition, the movable handle 33 has arm portions 112A, 112B. The arm part 112A is provided with an engaging protrusion 113A protruding in the inner peripheral direction, and the arm part 112B is provided with an engaging protrusion 113B protruding in the inner peripheral direction.

A slide member 115 is arranged on the outer peripheral direction side of the movable cylindrical member 46 . Engagement grooves 116 that are recessed toward the inner peripheral direction are formed on the sliding member 115 along the direction around the longitudinal axis. The movable handle 33 is attached to the slide member 115 by engaging the engaging protrusions 113A and 113B with the engaging groove 116 . The sliding member 115 is integrally rotatable with the movable cylindrical member 46 (sheath main body 41 ) relative to the movable handle 33 and the cylindrical housing 31 in directions around the longitudinal axis. The sliding member 115 is formed of an insulating material. Therefore, the movable cylindrical member 46 (sheath main body 41 ) and the movable handle 33 are electrically insulated.

In addition, a stopper 118 and a coil spring 117 as an elastic member are provided on the outer peripheral direction side of the movable cylindrical member 46 . One end of the coil spring 117 is connected to the tip of the slide member 115 , and the other end of the coil spring 117 is connected to the movable cylindrical member 46 . The length of the coil spring 117 in a natural state is L0. When the jaw 42 is not in contact with the object to be grasped or the moving conductive part 101 , the coil spring 117 is mounted between the movable cylindrical member 46 and the slide member 115 in a reference state contracted by the displacement x0 from the natural state. Therefore, when the jaw 42 is not in contact with the grasping object or the moving conductive part 101, the elastic coefficient of the coil spring 117 is k0, and the magnitude of the elastic force applied to the movable cylindrical member 46 from the coil spring 117 is k0x0. . In addition, movement of the slide member 115 in the proximal direction is restricted by the stopper 118 .

When the object to be grasped is held between the probe conductive part 23 (first electrode part 25) and the jaw 42 in the first treatment mode, or when the probe conductive part 23 (first electrode part 25) and the moving part are moved in the second treatment mode When the object to be grasped is grasped between the conductive parts 101 , the movable handle 33 is closed relative to the fixed handle 32 . As a result, the movable handle 33 rotates around the fulcrum pin 111 , and the slide member 115 , the movable cylindrical member 46 , and the inner tube 77 move toward the distal end along the longitudinal axis C integrally. At this time, the coil spring 117 is not contracted from the reference state, and the elastic force k0x0 applied to the movable cylindrical member 46 from the coil spring 117 remains unchanged. By moving the inner tube 77 in the distal direction, the jaw 42 is closed relative to the probe conductive portion 23 .

Furthermore, when the jaw 42 is in contact with the gripping object such as living tissue T in the first treatment mode, or when the jaw 42 is in contact with the moving conductive part 101 in the second treatment mode, the closing operation of the jaw 42 Temporarily stop. Therefore, the movement of the movable cylindrical member 46 and the inner tube 77 in the distal direction is temporarily stopped. In this state, when the movable handle 33 is further closed relative to the fixed handle 32 , the slide member 115 moves toward the distal end relative to the movable cylindrical member 46 .

The coil spring 117 is further contracted from the reference state by the movement of the slide member 115 relative to the movable cylindrical member 46 . If x is the displacement amount (contraction amount) of the coil spring 117 from the reference state, the elastic force applied to the movable cylindrical member 46 from the coil spring 117 when the coil spring 117 is further contracted from the reference state is k0 (x0+x), the elastic force is greater than the elastic force k0x0 in the reference state. By applying an elastic force k0 (x0+x) from the coil spring 117 to the movable cylindrical member 46 that is greater than the elastic force k0x0 in the reference state, the movable cylindrical member 46 and the inner tube 77 that are in the temporarily stopped state can be moved further. Move towards the top. As a result, the jaw 42 that is in contact with the object to be grasped or the moving conductive part 101 is further closed relative to the probe conductive part 23 . Therefore, compared with the situation when the coil spring 117 is in the reference state, the gap between the jaw 42 and the probe conductive part 23 (first electrode part 25), or between the moving conductive part 101 and the probe conductive part 23 (first electrode part 25) 25) The holding force for holding objects between objects has increased.

When the movable handle 33 is opened relative to the fixed handle 32 from the state of holding the grasped object between the jaw 42 and the probe conductive part 23, or between the moving conductive part 101 and the probe conductive part 23, the sliding The member 115 moves in the proximal direction relative to the movable cylindrical member 46 . Thereby, the coil spring 117 expands, and becomes a reference state. Also, the slide member 115 , the movable cylindrical member 46 , and the inner tube 77 move in the proximal direction along the longitudinal axis C in an integral manner. As the inner tube 77 moves in the proximal direction, the jaw 42 is opened relative to the probe conductive part 23 .

Next, the action of the grasping treatment device 1 of this embodiment will be described. When performing treatment in the first treatment mode using the grasping treatment device 1 , the operator moves the movement operation lever 83 as the movement operation input unit to the first operation position. Accordingly, the movable conductive part 101 is housed inside the sheath main body 41 and is located on the proximal direction side of the jaw 42 . In this state, the movable handle 33 is closed relative to the fixed handle 32 . Thus, according to the above-mentioned principle, it can be seen that the jaw part 42 performs a closing operation with respect to the probe conductive part 23 of the probe main body 21 (probe unit 3), so that a gap between the jaw part 42 and the probe conductive part 23 (first electrode part 25) is closed. Control objects such as blood vessels.

Then, when the operator presses the treatment mode input button 57A serving as the treatment mode input unit, the switch unit 58A is in the closed state. Accordingly, the first electrical signal path and the ground path are electrically connected by the switch portion 58A, and the electric signal is transmitted from the switch portion 58A to the control portion 10 of the power supply unit 7 . Next, an ultrasonic generating current is output from the ultrasonic generating current supply unit 8 , and a high-frequency current is output from the high-frequency current supply unit 9 .

Ultrasonic vibrations are generated in the ultrasonic vibrator 12 by supplying an electric current from the ultrasonic generating current supply unit 8 to the ultrasonic vibrator 12 via the electrical signal lines 13A and 13B. Then, the ultrasonic vibration is transmitted to the probe conductive part 23 (the tip part of the probe unit 3 ). The frictional heat generated by the ultrasonic vibration of the probe unit 3 coagulates or incises the grasped object held between the probe conductive portion 23 (tip portion of the probe body 21 ) and the jaw 42 .

In addition, the high-frequency current output from the high-frequency current supply unit 9 is transmitted to the probe conductive unit 23 via the electrical signal line 17 , the ultrasonic vibrator 12 , the horn 15 , and the probe main body 21 (probe unit 3 ). When the high-frequency current is transmitted, the probe conductive part 23 functions as the first electrode part 25 having the first potential E1.

In addition, the high-frequency current is transmitted from the high-frequency current supply part 9 to the jaw conductive part 93 via the electrical signal line 69 , the fourth conductive part 63D, the movable cylindrical member 46 , the inner tube 77 , and the jaw 42 . The jaw conductive portion 93 has a second potential E2 different in magnitude from the first potential E1 due to the high-frequency current being transmitted. When the movement operation lever 83 is located at the first operation position, the movable plate 81 and the movable cylindrical member 46 are electrically insulated. Therefore, a high-frequency current is not transmitted to the movable plate 81, and the moving conductive portion 101 does not function as an electrode. Therefore, in the first treatment mode, only the jaw conductive part 93 functions as the second electrode part 105 having the second potential E2.

Since the probe conductive part 23 (the first electrode part 25) has the first potential E1, and the jaw part conductive part 93 (the second electrode part 105) has the second potential E2, therefore, the high-frequency current flows into the probe conductive part that is grasped. 23 and the gripping object between the jaws 42. This denatures the object to be grasped, such as the living tissue T, and promotes its coagulation.

In the first treatment mode, since the moving conductive part 101 is located on the proximal side of the jaw 42, the probe conductive part 23 (probe obliquely facing surfaces 103A, 103B) of the first electrode part 25 and the second electrode The distance between the jaw conductive portions 93 (jaw inclined facing surfaces 98A, 98B) of the portion 105 is the first distance D1. In addition, even in the state where the probe main body 21 (probe unit 3) is vibrating ultrasonically, the first distance D1 has a distance that prevents contact between the first electrode part 25 and the second electrode part 105 (jaw conductive part 93). . Thereby, it is possible to effectively prevent failure of the grasping treatment device 1 due to a short circuit. In addition, in the first treatment mode, the probe main body 21 vibrates ultrasonically. Therefore, the pad member 95 capable of coming into contact with the probe conductive portion 23 in the state where the jaw 42 is closed with respect to the probe conductive portion 23 is abraded by the treatment in the first treatment mode. Therefore, even in the case where the pad member 95 is slightly worn due to the treatment in the first treatment mode, the first distance D1 has a distance from the beginning of use of the treatment device 1 so that the probe conductive part 23 (first electrode part 25) The distance that does not contact with the jaw conductive part 93 (second electrode part 105).

When performing treatment in the second treatment mode using the grasping treatment device 1 , the operator moves the movement operation lever 83 as the movement operation input unit to the second operation position. Thus, the movable conductive part 101 is located between the jaw vertically facing surface 97 (jaw 42 ) and the probe vertically facing surface 102 (first electrode part 25 ) in the opening and closing direction of the jaw 42 .

In this state, the movable handle 33 is closed relative to the fixed handle 32 . Thus, according to the above-mentioned principle, it can be seen that the jaw part 42 performs a closing operation with respect to the probe conductive part 23 of the probe main body 21 (probe unit 3), thereby being able to move the conductive part 101 and the probe conductive part 23 (the first electrode part 25). Between control objects such as blood vessels. At this time, by bringing the jaw 42 into contact with the movable conductive portion 101 , the movable conductive portion 101 is pressed by the jaw 42 in the closing direction of the jaw 42 . As a result, the object to be grasped is held between the probe conductive part 23 (first electrode part 25 ) and the moving conductive part 101 , and the object to be grasped is grasped.

Then, the operator presses the treatment mode input button 57B serving as the treatment mode input unit, whereby the switch unit 58B is in the closed state. Thereby, the second electric signal path and the ground path are electrically connected by the switch portion 58B, and the electric signal is transmitted from the switch portion 58B to the control portion 10 of the power supply unit 7 . Then, a high-frequency current is output from the high-frequency current supply unit 9 . At this time, no current is output from the ultrasonic generation current supply unit 8 .

The high-frequency current output from the high-frequency current supply unit 9 is transmitted to the probe conductive unit 23 via the electric signal line 17 , the ultrasonic vibrator 12 , the horn 15 , and the probe main body 21 (probe unit 3 ). When the high-frequency current is transmitted, the probe conductive part 23 functions as the first electrode part 25 having the first potential E1.

In addition, the high-frequency current is transmitted from the high-frequency current supply part 9 to the jaw conductive part 93 via the electrical signal line 69 , the fourth conductive part 63D, the movable cylindrical member 46 , the inner tube 77 , and the jaw 42 . The jaw conductive portion 93 has a second potential E2 having a magnitude different from the first potential E1 due to the high-frequency current being transmitted.

When the movement operation lever 83 is located at the second operation position, the movable plate 81 and the inner tube 77 (the movable cylindrical member 46 ) are electrically connected. Therefore, the high-frequency current is transmitted to the movable plate 81, and the moving conductive part 101 functions as the second electrode part 105 having the second potential E2. Therefore, in the second treatment mode, the jaw conductive part 93 and the moving conductive part 101 function as the second electrode part 105 having the second potential E2, and the moving conductive part 101 becomes a part of the second electrode part 105 . In addition, in the second treatment mode, ultrasonic vibration is not transmitted to the probe conductive part 23 (tip part of the probe unit 3 ), but only high-frequency current is transmitted to the first electrode part 25 and the second electrode part 105 .

Since the first electrode part 25 (probe conductive part 23) has a first potential E1, and the second electrode part 105 (jaw part conductive part 93 and moving conductive part 101) has a second potential E2, it is held on the probe conductive part 23. The high-frequency current is also applied to the object to be grasped between the moving conductive part 101 . Accordingly, it is possible to denature the object to be grasped, such as the living tissue T, and coagulate the object to be grasped.

In the second treatment mode, since the moving conductive part 101 (jaw part 42) is located between the jaw part 42 and the first electrode part 25 in the opening and closing direction of the jaw part 42, the probe conductive part of the first electrode part 25 The distance between 23 (probe vertical facing surface 102) and the moving conductive part 101 (movable part facing surface 106) of the second electrode part 105 is the second distance D2. The second distance D2 is smaller than the first distance D1. That is, the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode is smaller than that in the first treatment mode. Since the distance between the first electrode part 25 and the second electrode part 105 becomes smaller, compared with the first treatment mode, in the second treatment mode, the use of high-frequency current to make the living tissue T (holding object) is facilitated. transsexual. Therefore, the performance of coagulating the grasped object by the high-frequency current is improved, and therefore, even in the second treatment mode in which ultrasonic vibration is not used, the degradation of the coagulation performance of the grasped object is prevented. Thereby, even in the second treatment mode that does not use ultrasonic vibrations, the grasping object (living tissue) is stably sealed.

In addition, in the second treatment mode, the movable conductive part 101 is located between the jaw vertically facing surface (contact part) 97 and the probe vertically facing surface 102 in the opening and closing direction of the jaw 42 . Furthermore, the gripping object is gripped between the moving conductive part 101 and the probe conductive part 23 (first electrode part 25 ). The probe vertically opposite surface 102 of the probe conductive part 23 is perpendicular to the opening and closing direction of the jaw 42 . In addition, the movable part facing surface 106 of the moving conductive part 101 is approximately parallel to the probe vertically facing surface 102 and is opposite to the probe vertically facing surface 102 . Since the probe vertically facing surface 102 and the movable part facing surface 106 are perpendicular to the opening and closing direction of the jaw 42, the gripping object held between the moving conductive part 101 and the probe conductive part 23 (first electrode part 25) can be grasped. The holding power becomes larger. By increasing the gripping force, the performance of coagulating the gripped object with the high-frequency current is further improved. Thereby, it is possible to more stably seal the object to be grasped (living tissue).

Therefore, the grasping treatment device 1 configured as described above exhibits the following effects. That is, in the second treatment mode of the grasping treatment device 1 , the moving conductive part 101 is positioned between the jaw 42 and the probe conductive part 23 (first electrode part 25 ) in the opening and closing direction of the jaw 42 . Therefore, the distance between the probe conductive part 23 (probe vertical facing surface 102 ) of the first electrode part 25 and the moving conductive part 101 (movable part facing surface 106 ) of the second electrode part 105 becomes the second distance D2. The second distance D2 is smaller than the first distance D1. That is, the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode is smaller than that in the first treatment mode. Since the distance between the first electrode part 25 and the second electrode part 105 becomes smaller, compared with the first treatment mode, in the second treatment mode, the use of high-frequency current to make the living tissue T (holding object) is facilitated. degeneration. Therefore, the performance of coagulating the grasped object by high-frequency current is improved, and therefore, even in the second treatment mode that does not use ultrasonic vibrations, it is possible to prevent the degradation of the coagulation performance of the grasped object. Accordingly, even in the second treatment mode that does not use ultrasonic vibrations, it is possible to stably seal the gripping object (living tissue).

Modification of the first embodiment

In addition, in the second treatment mode of the first embodiment, the moving conductive part 101 is located between the jaw vertically facing surface (contact part) 97 and the probe vertically facing surface 102 in the opening and closing direction of the jaw 42, and the moving conductive part 101 The movable part facing surface 106 of the part 101 is perpendicular to the opening and closing direction of the jaw 42, but is not limited thereto. For example, as a first modified example, as shown in FIG. 16 , in the second treatment mode, the movable conductive part 101 may also be provided between the inclined opposing surface 98A of the jaw and the inclined facing surface 103A of the probe in the opening and closing direction of the jaw 42. between. In addition, in FIG. 16 , illustration of the living tissue T grasped between the jaw 42 and the probe main body 21 (the probe conductive portion 23 ) is omitted.

In this modified example, the moving conductive part 101 has a movable part facing surface 121 substantially parallel to the jaw inclined facing surface 98A and the probe inclined facing surface 103A. The movable part facing surface 121 is not perpendicular to the opening and closing direction of the jaw 42, and in the second treatment mode, the movable part facing surface 121 faces the probe inclined facing surface 103A.

In the first treatment mode of this modified example, the moving conductive part 101 is located on the proximal direction side of the jaw 42 . Therefore, the distance between the probe obliquely facing surface 103A and the jaw obliquely opposing surface 98A (the distance between the probe obliquely opposing surface 103B and the jaw obliquely opposing surface 98B) is the distance between the first electrode part 25 (probe The first distance D1 between the conductive part 23) and the second electrode part 105 (jaw conductive part 93). In the second treatment mode, the moving conductive part 101 is located between the jaw obliquely facing surface 98A and the probe obliquely facing surface 103A in the opening and closing direction of the jaw 42 . Therefore, the distance between the movable part facing surface 121 and the probe inclined facing surface 103A is the distance between the first electrode part 25 (probe conductive part 23) and the second electrode part 105 (moving conductive part 101) in the second treatment mode. The second distance D2.

As described above, in this modified example, the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode is also smaller than the distance between the first electrode part 25 and the second electrode part 105 in the first treatment mode. the distance between. Since the distance between the first electrode part 25 and the second electrode part 105 becomes smaller, compared with the first treatment mode, in the second treatment mode, the use of high-frequency current to make the living tissue T (holding object) is facilitated. degeneration.

In addition, in the first embodiment, the movable plate 81 is moved by the operation of moving the movement operation lever 83 along the longitudinal axis C between the first operation position and the second operation position, but the present invention is not limited thereto. For example, as a second modified example, as shown in FIGS. 17 and 18 , a movement operation button 122 may be provided as a movement operation input unit. The movement operation button 122 is formed of an insulating material, and is attached to the rotation operation knob 37 in a state where rotation in a direction around the longitudinal axis is restricted relative to the rotation operation knob 37 . An intermediary portion 123 formed of a conductive material is provided integrally with the movement operation button 122 on the inner peripheral direction side of the movement operation button 122 .

A movable plate (movable portion) 81 is provided between the inner sleeve 75 and the probe main body 21 (probe unit 3 ). The movable plate 81 is configured to be movable along the longitudinal axis C relative to the probe body 21 and the sheath body 41 . The movable plate 81 and the probe main body 21 are electrically insulated by the supporting member 85 . The intermediary portion 123 is provided with a button-side inclined surface 125A. In addition, a plate-side inclined surface 125B parallel to the button-side inclined surface 125A is provided at the base end portion of the movable plate 81 .

A protrusion 127 formed of an insulating material and protruding in the inner peripheral direction is provided on the inner peripheral portion of the rotary operation knob 37 . The protruding portion 127 is located on the proximal direction side of the proximal end of the movable plate 81 . A spring member 128 as an urging member is provided between the protrusion 127 and the movable plate 81 . One end of the spring member 128 is connected to the base end of the movable plate 81 , and the other end is connected to the protrusion 127 . The movable plate 81 is biased in the proximal direction by the spring member 128 .

As shown in FIG. 17 , in the first treatment mode, the operator does not press the movement operation button 122 , and the movement operation button 122 is located at the first operation position. At this time, the button-side inclined surface 125A of the intermediary portion 123 and the plate-side inclined surface 125B of the movable plate 81 are not in contact with each other, or are in a state of partial contact. Therefore, the movable plate 81 is not pressed by the relay part 123 . In addition, the movable plate 81 is biased in the proximal direction by the spring member 128 . Therefore, the moving conductive part 101 provided at the distal end of the movable plate 81 is housed inside the sheath main body 41 , and the moving conductive part 101 is located on the proximal direction side of the jaw 42 .

As shown in FIG. 18 , in the second treatment mode, when the operator presses the movement operation button 122 in the inner peripheral direction, the movement operation button 122 moves from the first operation position to the second operation position. Accordingly, the button-side inclined surface 127A of the intermediary portion 123 comes into contact with the plate-side inclined surface 127B of the movable plate 81 . At this time, the movable plate 81 is pressed toward the distal end by the relay portion 123 . Accordingly, the movable plate 81 moves toward the distal end against the urging force from the spring member 128 . Therefore, the moving conductive part 101 provided at the distal end of the movable plate 81 is located between the jaw 42 and the probe conductive part 23 (first electrode part 25 ) in the opening and closing direction of the jaw 42 .

As mentioned above, according to the first modified example and the second modified example, the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode is smaller than the distance between the first electrode part 25 and the second electrode part 105 in the first treatment mode. The structure of the distance between the two electrode parts 105 is not limited to the first embodiment. That is, it is sufficient as long as the movable part (movable plate 81) is installed in a state inserted into the inside of the sheath body 41, and the movable part (movable plate 81) can be positioned relative to the probe body 21 and the sheath body. The sleeve body 41 moves along the length axis C. As shown in FIG. And, as long as it is as follows: a moving conductive part 101 is provided at the front end part of the movable part (movable plate 81), and a moving operation input part (moving operation lever) for inputting an operation to move the movable part is provided. 83 or move the operation button 122). In this case, the movement conductive part 101 is positioned on the proximal direction side of the jaw 42 in the first treatment mode by an operation by the movement operation input part. In addition, the movement conductive part 101 is located between the jaw 42 and the first electrode part 25 in the opening and closing direction of the jaw 42 in the second treatment mode by an operation performed by the movement operation input part. In addition, in the second treatment mode, the moving conductive portion 101 functions as at least a part of the second electrode portion 105 by transmitting a high-frequency current through the movable portion (the movable plate 81 ).

2nd embodiment

Next, a second embodiment of the present invention will be described with reference to FIGS. 19 to 22 . The second embodiment is obtained by modifying the structure of the first embodiment as follows. In addition, the same code|symbol is attached|subjected to the same part as 1st Embodiment, and description is abbreviate|omitted.

19 and 20 are diagrams showing the structures of the distal end portion of the probe unit 3 and the jaw 42 . FIG. 19 shows a state in which the living tissue T is grasped and treated in the first treatment mode, and FIG. 20 shows a state in which the living tissue T is grasped and treated in the second treatment mode. As shown in FIGS. 19 and 20 , as in the first embodiment, a probe conductive portion 23 is provided at the distal end portion of the probe body 21 of the probe unit 3 .

21 and 22 are diagrams showing the internal structure of the rotary operation knob 37 . FIG. 21 shows the first processing mode, and FIG. 22 shows the second processing mode. As shown in FIGS. 21 and 22 , the probe unit 3 penetrating through the sheath body 41 has a movable plate 131 as a movable portion provided on the inner circumferential side of the inner sheath 75 along the longitudinal axis C. The movable plate 131 is formed of a conductive material such as metal. The movable plate 131 is movable along the longitudinal axis C relative to the probe body 21 and the sheath body 41 (the sheath unit 5 ). The movable plate 131 is electrically insulated from the sheath main body 41 (inner tube 77 ) by the inner sleeve 75 . In addition, the probe main body 21 and the sheath main body 41 are electrically insulated by the support member 85 and the inner sleeve 75 . Therefore, the probe unit 3 and the sheath unit 5 are electrically insulated.

The movable plate 131 is fixed to a movement operation button 133 as a movement operation input part via a relay part 132 formed of a conductive material. The movement operation button 133 is formed of an insulating material. The movement operation button 133 is connected to the rotation operation knob 37 in a state where the rotation in the direction around the longitudinal axis relative to the rotation operation knob 37 is restricted. In addition, an insulating coating is applied to a part of the surface of the relay portion 132 to form an insulating layer portion 135 . By providing the insulating layer portion 135 , it is possible to always prevent contact between the inner tube 77 and the relay portion 132 . Thus, the movable plate 131 is always insulated from the inner tube 77 (sheath unit 5 ). The intermediary portion 132 is provided with a plate-side inclined surface 137A. Further, a sheath-side inclined surface 137B parallel to the plate-side inclined surface 137A is provided at the base end portion of the inner sleeve 75 of the sheath main body 41 .

A protrusion 138 formed of an insulating material and protruding in the inner peripheral direction is provided on the inner peripheral portion of the rotary operation knob 37 . The protruding portion 138 is located on the proximal side of the intermediary portion 132 . A spring member 139 as an urging member is provided between the protruding portion 138 and the relay portion 132 . One end of the spring member 139 is connected to the insulating layer part 135 , and the other end is connected to the protrusion part 138 . The relay part 132 and the movable plate 131 are biased in the proximal direction by the spring member 139 .

The movable plate 131 moves along the longitudinal axis C relative to the probe main body 21 and the sheath main body 41 by an operation by moving the operation button 133 . That is, an operation to move the movable plate 131 as a movable portion along the longitudinal axis C is input using the movement operation button 133 .

As shown in FIG. 21 , in the first treatment mode, the operator does not press the movement operation button 133 and the movement operation button 133 is located at the first operation position. At this time, the plate-side inclined surface 137A of the relay portion 132 is in contact with the sheath-side inclined surface 137B of the inner sleeve 75 . In addition, the movable plate 131 is biased in the proximal direction by the spring member 139 . A moving conductive portion 141 is provided at the tip end portion of the movable plate 131 . In the first treatment mode in which the movement operation button 133 is located at the first operation position, the movable plate 131 is urged in the proximal direction, so the movement conductive part 141 is housed inside the sheath body 41 . That is, the moving conductive portion 141 is located on the proximal direction side of the jaw 42 (see FIG. 19 ).

Furthermore, when the movement operation button 133 is located at the first operation position, the movable plate 131 and the relay part 132 are not in contact with the probe main body 21 . Therefore, the movable plate 131 is electrically insulated from the probe body 21 , and high-frequency current is not transmitted from the probe body 21 to the movable plate 131 .

As shown in FIG. 19 , the probe conductive part 23 has the probe vertically facing surface 102 and the probe obliquely facing surfaces 103A and 103B, similarly to the first embodiment. Similar to the first embodiment, the probe conductive part 23 can be made to function as the first electrode part 25 having the first potential E1 by being transmitted with a high-frequency current.

In addition, a jaw vertically facing surface 142 parallel to the probe vertically facing surface 102 is formed on the jaw 42 by the jaw conductive portion 93 . The probe vertically facing surface 102 faces the jaw vertically facing surface 142 in the first treatment mode. A first jaw inclined facing surface 143A is formed by the pad member 95 on the side of the jaw perpendicular facing surface 142 in the width direction perpendicular to the longitudinal axis C and the opening and closing direction of the jaw 42 . In addition, on the other side of the jaw vertically facing surface 142 in the width direction, a second jaw obliquely facing surface 143B is formed by the jaw conductive portion 93 . The first jaw obliquely facing surface 143A is substantially parallel to the probe obliquely facing surface 103A, and is opposed to the probe obliquely facing surface 103A. In addition, the second jaw obliquely facing surface 143B is substantially parallel to the probe obliquely opposing surface 103B, and is opposed to the probe obliquely opposing surface 103B.

When there is no grasping object such as a blood vessel (biological tissue) between the probe conductive part 23 (first electrode part 25) and the jaw 42, and the movement operation button 133 is located at the first operation position, the forceps When the member 42 is closed relative to the probe conductive part 23 , the first jaw obliquely facing surface 143A abuts against the probe obliquely facing surface 103A of the probe conductive part 23 . That is, in a state where the jaw 42 is closed with respect to the probe conductive part 23 , the first jaw inclined facing surface (abutting part) 143A can come into contact with the probe conductive part 23 . In the state where the jaw 42 is closed relative to the probe conductive part 23, a gap is always formed between the probe inclined facing surface 103B and the second jaw facing inclined surface 143B, and the probe vertical facing surface 102 and the jaw vertical facing surface 142 There is always a gap between them. That is, in a state where the first jaw inclined facing surface (contact portion) 143A of the pad member (insulating contact member) 95 is in contact with the probe conductive portion 23 (probe inclined facing surface 103A), the jaw conductive portion 93 There is a gap between (the jaw vertically facing surface 142 and the second jaw obliquely facing surface 143B) and the probe conductive part 23 (first electrode part 25 ).

As shown in FIG. 19 , in the first treatment mode, an ultrasonic generating current is output from the ultrasonic generating current supply unit 8 . Therefore, ultrasonic vibration is generated by the ultrasonic vibrator 12 , and the ultrasonic vibration is transmitted to the probe conductive portion 23 (tip portion of the probe unit 3 ). In addition, in the first treatment mode, a high-frequency current is output from the high-frequency current supply unit 9 . Therefore, the high-frequency current is transmitted to the probe conductive part 23, so that the probe conductive part 23 has the first potential E1. In addition, the high-frequency current is transmitted to the jaw conductive part 93 of the jaw 42, and the jaw conductive part 93 becomes the second electrode part 105 having the second potential E2. At this time, since the high-frequency current is not transmitted to the movable plate 131, the movable conductive portion 141 does not function as an electrode.

Therefore, in the first treatment mode, only the probe conductive part 23 functions as the first electrode part 25 having the first potential E1. In the first treatment mode, the distance between the probe conductive portion 23 (probe vertically opposite surface 102) of the first electrode portion 25 and the jaw conductive portion 93 (jaw vertically opposite surface 142) of the second electrode portion 105 is the second 1 distance D1.

As shown in FIG. 22 , in the second treatment mode, when the operator presses the movement operation button 133 in the inner peripheral direction, the movement operation button 133 moves from the first operation position to the second operation position. As a result, the plate-side inclined surface 137A of the intermediary portion 132 slides on the sheath-side inclined surface 137B of the inner sleeve 75 . Accordingly, the movable plate 131 moves toward the distal end against the urging force from the spring member 139 . Here, when the movement operation button 133 is located at the second operation position, the movable plate 131 is in contact with the probe main body 21 . Therefore, the movable plate 131 is electrically connected to the probe body 21 , so that high-frequency current is transmitted from the probe body 21 to the movable plate 131 . When the high-frequency current is transmitted to the movable plate 131, the moving conductive part 141 has the first potential E1.

As shown in FIG. 20 , in the second treatment mode, through the operation of moving the moving operation button 133 to the second operating position, the moving conductive part 141 is located on the vertically opposite surface 142 of the jaw 42 in the opening and closing direction of the jaw 42 ( Jaws 42) and the probe vertically opposite surface 102 (probe conductive part 23). The moving conductive part 141 has a movable part facing surface 145 perpendicular to the opening and closing direction of the jaw 42 . In the second treatment mode in which the movement operation button 133 is located at the second operation position, the movable part facing surface 145 is parallel to the jaw vertically facing surface 142 and faces the jaw vertically facing surface 142 . The distance between the movable part facing surface 145 (moving conductive part 141 ) and the jaw vertical facing surface 142 (second electrode part 105 ) is a second distance D2 smaller than the first distance D1.

In the second treatment mode, the ultrasonic generating current is not output from the ultrasonic generating current supply unit 8 , and only the high frequency current is output from the high frequency current supply unit 9 . Therefore, the ultrasonic vibrator 12 does not generate ultrasonic vibrations. In addition, the high-frequency current is transmitted to the probe conductive part 23, so that the probe conductive part 23 has the first potential E1. In addition, the high-frequency current is transmitted to the jaw conductive part 93 of the jaw 42, and the jaw conductive part 93 becomes the second electrode part 105 having the second potential E2. At this time, since the high-frequency current is transmitted from the probe main body 21 to the movable plate (movable part) 131, the moving conductive part 141 also has the first potential E1.

Therefore, in the second treatment mode, the probe conductive part 23 and the moving conductive part 141 function as the first electrode part 25 having the first potential E1 , and the moving conductive part 141 becomes a part of the first electrode part 25 . Therefore, in the second treatment mode, the distance between the moving conductive portion 141 (movable portion facing surface 145) of the first electrode portion 25 and the jaw conductive portion 93 (jaw vertically facing surface 142) of the second electrode portion 105 The distance is a second distance D2 smaller than the first distance D1.

As described above, the moving operation button (moving operation input unit) 133 serves as inter-electrode distance changing means for making the second distance D2 smaller than the first distance D1, wherein the first distance D1 refers to the first distance in the first treatment mode. The distance between the electrode part 25 and the second electrode part 105, the second distance D2 refers to the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode. Moreover, in the second treatment mode, the probe conductive part 23 and the moving conductive part 141 (the tip part of the probe unit 3) are not transmitted with ultrasonic vibration, but only high-frequency current is transmitted to the first electrode part 25 and the second electrode part 25. electrode part 105 .

Next, the action of the grasping treatment device 1 of this embodiment will be described. When performing treatment in the first treatment mode using the grasping treatment device 1 , the operator moves the movement operation button 133 as the movement operation input unit to the first operation position. As a result, the movable conductive portion 141 is accommodated inside the sheath main body 41 and is located on the proximal direction side of the jaw 42 . In this state, the movable handle 33 is closed relative to the fixed handle 32 . As a result, as described in the first embodiment, the jaw 42 closes the probe conductive portion 23 of the probe main body 21 (probe unit 3 ), thereby grasping objects such as blood vessels between the jaw 42 and the probe conductive portion. Between 23.

Then, the operator presses the treatment mode input button 57A serving as the treatment mode input unit, thereby bringing the switch unit 58A into a closed state. As a result, the ultrasonic generating current is output from the ultrasonic generating current supply unit 8 , and the high-frequency current is output from the high-frequency current supply unit 9 . Thereafter, ultrasonic vibration is generated by the ultrasonic vibrator 12 , and the ultrasonic vibration is transmitted to the probe conductive portion 23 (tip portion of the probe unit 3 ). The frictional heat generated by the ultrasonic vibration of the probe unit 3 coagulates or cuts the grasped object grasped between the probe conductive portion 23 (tip portion of the probe body 21 ) and the jaw 42 .

In addition, the high-frequency current output from the high-frequency current supply unit 9 is transmitted to the probe conductive unit 23 via the electrical signal line 17 , the ultrasonic vibrator 12 , the horn 15 , and the probe main body 21 (probe unit 3 ). The probe conductive part 23 has the first potential E1 by being transmitted with a high-frequency current. In addition, the high-frequency current is transmitted from the high-frequency current supply part 9 to the jaw conductive part 93 via the electrical signal line 69 , the fourth conductive part 63D, the movable cylindrical member 46 , the inner tube 77 , and the jaw 42 . When the high-frequency current is transmitted, the jaw conductive part 93 functions as the second electrode part 105 having a second potential E2 different in magnitude from the first potential E1 .

When the movement operation lever 83 is located at the first operation position, the movable plate 131 is electrically insulated from the probe main body 21 . Therefore, the high-frequency current is not transmitted to the movable plate 131, and the movable conductive portion 141 does not function as an electrode. Therefore, in the first treatment mode, only the probe conductive part 23 functions as the first electrode part 25 having the first potential E1. Since the probe conductive part 23 (the first electrode part 25) has the first potential E1, and the jaw conductive part 93 (the second electrode part 105) has the second potential E2, therefore, the probe conductive part 23 and the jaw part 42 held on A high-frequency current is passed between the holding objects. Thereby, it is possible to denature the object to be grasped, such as the living tissue T, and to promote coagulation of the object to be grasped.

When performing treatment in the second treatment mode using the grasping treatment device 1 , the operator moves the movement operation button 133 as the movement operation input unit to the second operation position. Thus, the moving conductive part 141 is located between the jaw vertically facing surface 142 (jaw part 42 ) and the probe vertically facing surface 102 (probe conductive part 23 ) in the opening and closing direction of the jaw part 42 .

In this state, the movable handle 33 is closed relative to the fixed handle 32 . Thereby, as described in the above-mentioned first embodiment, the jaw 42 performs a closing action relative to the probe conductive portion 23 of the probe main body 21 (probe unit 3 ), thereby grasping a grasping object such as a blood vessel between the moving conductive portion 141 and the jaw. between the conductive parts 93 (second electrode part 105). At this time, the object to be grasped is held between the moving conductive part 141 and the jaw conductive part 93 (second electrode part 105 ), and the object to be grasped is grasped.

Then, the operator presses the treatment mode input button 57B serving as the treatment mode input unit to bring the switch unit 58B into the closed state. Thus, a high-frequency current is output from the high-frequency current supply unit 9 . At this time, no current is output from the ultrasonic generation current supply unit 8 . The high-frequency current output from the high-frequency current supply part 9 is transmitted to the probe conductive part 23 via the electric signal line 17 , the ultrasonic vibrator 12 , the horn 15 , and the probe main body 21 (probe unit 3 ). The probe conductive part 23 has the first potential E1 by receiving high-frequency current. Further, the high-frequency current is transmitted from the high-frequency current supply part 9 to the jaw conductive part 93 via the electrical signal line 69 , the fourth conductive part 63D, the movable cylindrical member 46 , the inner tube 77 , and the jaw 42 . When the high-frequency current is transmitted, the jaw conductive part 93 functions as the second electrode part 105 having a second potential E2 different in magnitude from the first potential E1 .

When the movement operation button 133 is located at the second operation position, the movable plate 131 is electrically connected to the probe main body 21 . Therefore, a high-frequency current is transmitted to the movable plate 131, and the moving conductive portion 141 functions as the first electrode portion 25 having the first potential E1. Therefore, in the second treatment mode, the probe conductive part 23 and the moving conductive part 141 function as the first electrode part 25 having the first potential E1 , and the moving conductive part 141 becomes a part of the first electrode part 25 . In addition, in the second treatment mode, ultrasonic vibration is not transmitted to the probe conductive part 23 and the moving conductive part 141 (the tip part of the probe unit 3 ), but only high-frequency current is transmitted to the first electrode part 25 and the second electrode part 25 . electrode part 105 .

Since the first electrode part 25 (the probe conductive part 23 and the mobile conductive part 141) has the first potential E1, and the second electrode part 105 (the jaw part conductive part 93) has the second potential E2, it can conduct electricity to the grasped object. A high-frequency current is supplied to the grasped object between the portion 141 and the jaw 42 . Thereby, the object to be grasped such as the living tissue T can be denatured, and the object to be grasped can be coagulated.

In the second treatment mode, since the moving conductive part 141 is located between the jaw part 42 and the probe conductive part 23 in the opening and closing direction of the jaw part 42, the moving conductive part 141 of the first electrode part 25 (the movable part faces surface 145 ) and the jaw conductive portion 93 (jaw vertically facing surface 142 ) of the second electrode portion 105 becomes the second distance D2. The second distance D2 is smaller than the first distance D1. That is, the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode is smaller than that in the first treatment mode. Since the distance between the first electrode part 25 and the second electrode part 105 becomes smaller, compared with the first treatment mode, in the second treatment mode, the use of high-frequency current to make the living tissue T (holding object) is facilitated. degeneration. Therefore, the performance of coagulating the grasped object by the high-frequency current is improved, and therefore, even in the second treatment mode in which ultrasonic vibration is not used, the degradation of the coagulation performance of the grasped object is prevented. Accordingly, even in the second treatment mode that does not use ultrasonic vibrations, it is possible to stably seal the gripping object (living tissue).

In addition, in the second treatment mode, the moving conductive portion 141 is located between the jaw vertically facing surface 142 (jaw conductive portion 93 ) and the probe vertically facing surface 102 in the opening and closing direction of the jaw 42 . Furthermore, the gripping object is gripped between the moving conductive portion 141 and the jaw 42 (second electrode portion 105 ). The jaw vertically opposite surface 142 of the jaw conductive portion 93 is perpendicular to the opening and closing direction of the jaw 42 . In addition, the movable portion opposing surface 145 of the moving conductive portion 141 is parallel to the jaw vertically opposing surface 142 and is opposite to the jaw vertically opposing surface 142 . Since the jaw vertically facing surface 142 and the movable part facing surface 145 are perpendicular to the opening and closing direction of the jaw 42, the grip between the moving conductive part 141 and the jaw conductive part 93 (second electrode part 105) is grasped. The gripping force of the gripping object becomes stronger. By increasing the gripping force, the performance of coagulating the gripped object with the high-frequency current is further improved. Thereby, it is possible to more stably seal the object to be grasped (living tissue).

Therefore, the grasping treatment device 1 configured as described above exhibits the following effects. That is, in the second treatment mode in which the treatment device 1 is grasped, the moving conductive part 141 is located between the jaw 42 and the probe conductive part 23 in the opening and closing direction of the jaw 42 . Therefore, the distance between the moving conductive portion 141 (movable portion facing surface 145) of the first electrode portion 25 and the jaw conductive portion 93 (jaw vertically facing surface 142) of the second electrode portion 105 becomes the second distance D2. . The second distance D2 is smaller than the first distance D1. That is, the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode is smaller than that in the first treatment mode. Since the distance between the first electrode part 25 and the second electrode part 105 becomes smaller, compared with the first treatment mode, in the second treatment mode, the use of high-frequency current to make the living tissue T (holding object) is facilitated. degeneration. Therefore, the performance of coagulating the grasped object by high-frequency current is improved, and therefore, even in the second treatment mode that does not use ultrasonic vibrations, it is possible to prevent the degradation of the coagulation performance of the grasped object. Accordingly, even in the second treatment mode that does not use ultrasonic vibrations, it is possible to stably seal the gripping object (living tissue).

Modification of the second embodiment

In addition, in the second treatment mode of the second embodiment, the moving conductive part 141 is located between the jaw vertically facing surface 142 (jaw part conductive part 93 ) and the probe vertically facing surface 102 in the opening and closing direction of the jaw 42, The movable portion facing surface 145 of the movable conductive portion 141 is perpendicular to the opening and closing direction of the jaw 42 , but is not limited thereto. For example, the configuration shown in FIG. 23 can also be applied as a modified example. In addition, in FIG. 23 , the illustration of the living tissue T grasped between the jaw 42 and the probe main body 21 (the probe conductive part 23 ) is omitted.

As shown in FIG. 23 , in this modified example, the jaw 42 has the same structure as that of the first embodiment, and has a jaw vertically facing surface 97 and jaw obliquely facing surfaces 98A, 98B. That is, the positional relationship between the jaw conductive portion 93 and the pad member (insulation contact member) 95 is the same as that of the first embodiment.

Furthermore, in the second treatment mode, the moving conductive part 141 is provided between the jaw obliquely facing surface 98A and the probe obliquely facing surface 103A in the opening and closing direction of the jaw 42 . In this modified example, the moving conductive part 141 has a movable part facing surface 147 substantially parallel to the jaw inclined facing surface 98A and the probe inclined facing surface 103A. The movable portion facing surface 147 is not perpendicular to the opening and closing direction of the jaw 42 , and the movable portion facing surface 147 faces the jaw inclined facing surface 98A in the second treatment mode.

Also in this modified example, the moving conductive portion 141 is located on the proximal direction side of the jaw 42 in the first treatment mode. Therefore, the distance between the probe obliquely facing surface 103A and the jaw obliquely opposing surface 98A (the distance between the probe obliquely opposing surface 103B and the jaw obliquely opposing surface 98B) is the distance between the first electrode part 25 (probe The first distance D1 between the conductive part 23) and the second electrode part 105 (jaw conductive part 93). In the second treatment mode, the moving conductive part 141 is positioned between the jaw obliquely facing surface 98A and the probe obliquely facing surface 103A in the opening and closing direction of the jaw 42 . Therefore, the distance between the movable part facing surface 147 and the inclined jaw facing surface 98A becomes the distance between the first electrode part 25 (moving conductive part 141) and the second electrode part 105 (jaw conductive part 93) in the second treatment mode. The second distance D2 between.

As described above, in this modified example, the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode is also smaller than the distance between the first electrode part 25 and the second electrode part 105 in the first treatment mode. the distance between. Since the distance between the first electrode part 25 and the second electrode part 105 becomes smaller, compared with the first treatment mode, in the second treatment mode, the use of high-frequency current to make the living tissue T (holding object) is facilitated. degeneration. However, this modified example is different from the first embodiment in that the movable portion facing surface 145 perpendicular to the opening and closing direction of the jaw 42 is not provided on the moving conductive portion 141 . Therefore, compared with the second embodiment, the force for grasping the grasped object in the second treatment mode of this modified example is reduced.

As mentioned above, according to the modified example, the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode is smaller than the distance between the first electrode part 25 and the second electrode part 105 in the first treatment mode. The configuration of the distance is not limited to the second embodiment. That is, the movable part (movable plate 131 ) provided in the probe unit 3 may move along the longitudinal axis C relative to the probe body 21 and the sheath body 41 . Moreover, it is sufficient as long as it is as follows: a moving conductive part 141 is provided at the top end of the movable part (movable plate 131), and a moving operation input part (moving operation button 133) for inputting an operation to move the movable part is provided. ). In this case, the movement conductive part 141 is positioned on the proximal direction side of the jaw 42 in the first treatment mode by an operation by the movement operation input part. Furthermore, the movement conductive part 141 is positioned between the jaw 42 and the probe conductive part 23 in the opening and closing direction of the jaw 42 in the second treatment mode by an operation by the movement operation input part. In addition, in the second treatment mode, the moving conductive portion 141 functions as at least a part of the first electrode portion 25 by transmitting a high-frequency current through the movable portion (the movable plate 131 ).

third embodiment

Next, a third embodiment of the present invention will be described with reference to FIGS. 24 to 30 . The third embodiment is obtained by modifying the structure of the first embodiment as follows. In addition, the same code|symbol is attached|subjected to the same part as 1st Embodiment, and description is abbreviate|omitted.

24 and 25 are diagrams showing the structures of the distal end portion of the probe unit 3 and the jaw 42 . FIG. 24 shows the first processing mode, and FIG. 25 shows the second processing mode. As shown in FIGS. 24 and 25 , this embodiment is different from the first and second embodiments in that no movable portion (movable plates 81 and 131 ) is provided. Therefore, by transmitting high-frequency current through the probe main body 21 (probe unit 3 ), only the probe conductive part 23 functions as the first electrode part 25 having the first potential E1. Furthermore, by transmitting high-frequency current through the sheath main body 41 (sheath unit 5 ), only the jaw conductive part 93 functions as the second electrode part 105 having the second potential E2. The jaw 42 has the same structure as the jaw of the first embodiment, and has a jaw vertically facing surface 97 and jaw obliquely facing surfaces 98A, 98B.

As shown in Figure 24, the probe conductive part 23 has: the first probe vertically opposite surface 151A; ° set by way of angle. In the first treatment mode, the first probe vertically facing surface 151A is arranged perpendicular to the opening and closing direction of the jaw 42 (that is, parallel to the jaw vertically facing surface 97 ). In the first treatment mode, the jaw vertically facing surface (abutting portion) 97 of the pad member 95 can be brought into contact with the first probe vertically facing surface 151A.

In the first treatment mode, a first probe obliquely facing surface 152A is provided on the side of the first probe vertically facing surface 151A in a direction perpendicular to the longitudinal axis C and perpendicular to the opening and closing direction of the jaw 42, that is, in the width direction. . In addition, a second probe obliquely facing surface 152B is provided on the other side of the first probe perpendicularly facing surface 151A in the width direction. The second probe obliquely facing surface 152B is provided between the first probe vertically facing surface 151A and the second probe vertically facing surface 151B. The second probe obliquely facing surface 152B is provided at an angle of approximately 90° from the first probe obliquely facing surface 152A in the direction around the longitudinal axis.

In the first treatment mode, the first probe obliquely facing surface 152A is substantially parallel to the jaw obliquely facing surface 98A, and is opposed to the jaw obliquely facing surface 98A. Furthermore, the second probe obliquely facing surface 152B is substantially parallel to the jaw obliquely facing surface 98B, and is opposed to the jaw obliquely facing surface 98B. That is, the first electrode facing surface 153 facing the jaw conductive part 93 in the first treatment mode is formed by the first probe obliquely facing surface 152A and the second probe obliquely facing surface 152B.

In the state where the jaw vertically facing surface (contact portion) 97 is in contact with the first probe vertically facing surface 151A (probe conductive portion 23), the first electrode facing surface 153 (first electrode portion 25) and the jaw conductive portion 93 (second electrode portion 105 ) has a gap formed therebetween. In the first treatment mode, the first electrode facing surface 153 (the first probe obliquely facing surface 152A and the second probe obliquely facing surface 152B) of the first electrode part 25 is in contact with the jaw conductive part 93 (forceps) of the second electrode part 105. The distance between the component inclined facing surfaces 98A, 98B) is the first distance D1. Accordingly, the first electrode-facing surface 153 faces the jaw conductive portion 93 at a distance D1 from the jaw conductive portion 93 .

As shown in FIG. 25, in the second treatment mode, the probe conductive part 23 (probe unit 3) is rotated approximately 90° in the direction around the longitudinal axis relative to the jaw 42 and the sheath unit 5 from the first treatment mode. The state configuration after the rotation angle. Therefore, in the second treatment mode, the second probe vertically facing surface 151B is arranged perpendicular to the opening and closing direction of the jaw 42 (that is, parallel to the jaw vertically facing surface 97 ). In the second treatment mode, the jaw vertically facing surface (contact portion) 97 of the pad member 95 can be brought into contact with the second probe vertically facing surface 151B.

In the second treatment mode, a second probe obliquely facing surface 152B is provided on the side of the second probe vertically facing surface 151B in the direction perpendicular to the longitudinal axis C and perpendicular to the opening and closing direction of the jaw 42, that is, the width direction. . Furthermore, a third probe obliquely facing surface 152C is provided on the other side of the second probe perpendicularly facing surface 151B in the width direction. The third probe obliquely facing surface 152C is provided at an angle of approximately 90° from the second probe obliquely facing surface 152B in the direction around the longitudinal axis, and the third probe obliquely facing surface 152C is arranged in a direction around the longitudinal axis. It is arranged at an angle of approximately 180° from the first probe obliquely facing surface 152A.

In the second treatment mode, the second probe obliquely facing surface 152B is substantially parallel to the jaw obliquely facing surface 98A, and is opposed to the jaw obliquely facing surface 98A. In addition, the third probe obliquely facing surface 152C is substantially parallel to the jaw obliquely facing surface 98B, and is opposed to the jaw obliquely facing surface 98B. That is, the second electrode facing surface 155 facing the jaw conductive part 93 in the second treatment mode is formed by the second probe obliquely facing surface 152B and the third probe obliquely facing surface 152C. Since the probe obliquely facing surfaces 152A to 152C are arranged as described above, the second electrode facing surface 155 is separated from the first electrode facing surface 153 at an angle of approximately 90° in the direction around the longitudinal axis. configuration.

In the state where the jaw vertically facing surface (contact portion) 97 is in contact with the second probe vertically facing surface 151B (probe conductive portion 23), the second electrode facing surface 155 (first electrode portion 25) and the jaw conductive portion 93 (second electrode portion 105 ) has a gap formed therebetween. In the second treatment mode, the second electrode facing surface 155 (the second probe obliquely facing surface 152B and the third probe obliquely facing surface 152C) of the first electrode part 25 is in contact with the jaw conductive part 93 (forceps) of the second electrode part 105. The distance between member inclined facing surfaces 98A, 98B) is a second distance D2 smaller than the first distance D1. Therefore, the second electrode facing surface 155 faces the jaw conductive part 93 with a second distance D2 smaller than the first distance D1 from the jaw conductive part 93 .

26 and 27 are diagrams showing the internal structure of the rotary operation knob 37 . FIG. 28 is a sectional view taken along line 28-28 in FIG. 26 , and FIG. 29 is a sectional view taken along line 29-29 in FIG. 27 . 26 and 28 show a state in which the relative rotation of the probe unit 3 and the sheath unit 5 cannot rotate relative to each other in the direction around the longitudinal axis when the treatment is performed in the first treatment mode.

As shown in FIGS. 26 and 28 , in this embodiment, engaging pins 47A and 47B are provided in the same manner as in the first embodiment. Further, the movable cylindrical member 46 is provided with through holes 48A, 48B, and the connecting cylindrical member 45 is provided with engagement recessed portions 49A, 49B. The connecting cylindrical member 45 is provided with two engaging recessed parts 49C and 49D in addition to the engaging recessed parts 49A and 49B. The engagement recesses 49C and 49D are provided at an angle of approximately 180° relative to each other in the direction around the longitudinal axis. Furthermore, each of the engaging recessed portions 49C and 49D is provided at an angle of approximately 90° from the engaging recessed portion 49A in the direction around the longitudinal axis.

The engagement pin 47A is fixed to a rotation state switching lever 161A as a rotation state switching portion, and the engagement pin 47B is fixed to a rotation state switching lever 161B as a rotation state switching portion. The rotation state switching levers 161A, 161B are spaced apart from each other by a certain distance in the direction around the longitudinal axis. Each rotation state switching lever 161A, 161B is attached to the rotation operation knob 37 in a state capable of moving between a first operation position and a second operation position by operation of the operator.

In the first treatment mode and in a state where relative rotation is restricted, each rotation state switching lever 161A, 161B is located at the first operation position. At this time, the engaging pin 47A penetrates through the through hole 48A, and engages with the engaging recessed portion 49A. In addition, the engaging pin 47B passes through the through hole 48B, and engages with the engaging recessed portion 49B. The connecting cylindrical member 45 is fixed to the rotary operation knob 37 by engaging the respective engaging pins 47A, 47B with the corresponding engaging recesses 49A, 49B. In addition, by passing the engaging pins 47A, 47B through their corresponding through-holes 48A, 48B, the movable cylindrical member 46 and the rotational operation knob 37 can be restrained from being able to rotate in directions around the longitudinal axis relative to each other. status. With the configuration as above, the connecting cylindrical member 45 and the movable cylindrical member 46 (the sheath unit 5 and the jaw 42 ) can be rotated integrally with the operating knob 37 in a direction around the longitudinal axis with respect to the cylindrical housing 31 . rotate.

Also, when the rotational operation knob 37 is rotated in a direction around the longitudinal axis, the rotational driving force from the rotational operation knob 37 is transmitted to the probe main body 21 (probe unit 3 ) via the connection cylindrical member 45 and the elastic member 51 . Thus, the probe unit 3 is rotatable relative to the cylindrical housing 31 integrally with the rotary operation knob 37 and the connecting cylindrical member 45 . As described above, in the state where the relative rotation is restricted, the rotation operation knob 37 serving as the rotation operation input part is input to rotate the probe unit 3, the sheath unit 5, and the jaw 42 integrally in the direction around the longitudinal axis. operate. That is, in a state where relative rotation is restricted, the sheath unit 5 and the probe unit 3 cannot rotate relative to each other in directions around the longitudinal axis.

FIGS. 27 and 29 show a relative rotatable state in which the sheath unit 5 and the probe unit 3 are rotatable relative to each other in a direction around the longitudinal axis. In the relatively rotatable state, each rotation state switching lever 161A, 161B is moved from the first operation position to the second operation position by the operator's operation. At this time, although the engaging pin 47A is inserted into the through hole 48A, it is not engaged with any of the engaging recessed portion 49A to the engaging recessed portion 49D. In addition, although the engaging pin 47B is inserted into the through-hole 48B, it is not engaged with any of the engaging recessed part 49A - engaging recessed part 49D. Since each of the engaging pins 47A and 47B is not engaged with any of the engaging recessed portion 49A to the engaging recessed portion 49D, the connecting cylindrical member 45 is not fixed to the rotary operation knob 37 . Thus, the connecting cylindrical member 45 and the rotational operation knob 37 are rotatable relative to each other in the direction around the longitudinal axis.

On the other hand, the engaging pins 47A, 47B are inserted into the corresponding through-holes 48A, 48B. Therefore, the movable cylindrical member 46 and the rotational operation knob 37 are restricted in a state where they cannot rotate relative to each other in the direction around the longitudinal axis. Therefore, the movable cylindrical member 46 (the sheath unit 5 and the jaw 42 ) can be rotated in a direction around the longitudinal axis with respect to the cylindrical housing 31 integrally with the rotation operation knob 37 .

In a relatively rotatable state, the connecting cylindrical member 45 is not fixed to the rotary operation knob 37 . Therefore, when the rotational operation knob 37 is rotated in a direction around the longitudinal axis, the rotational driving force from the rotational operation knob 37 is not transmitted to the connecting cylindrical member 45 . Therefore, the rotational operation of the rotational operation knob 37 is not transmitted to the probe main body 21 (probe unit 3 ) fixed to the connecting cylindrical member 45 . That is, the probe unit 3 and the rotation operation knob 37 are rotatable relative to each other in directions around the longitudinal axis.

As described above, in a relatively rotatable state, an operation to rotate the sheath unit 5 and the jaw 42 relative to the probe unit 3 in a direction around the longitudinal axis is input by the rotation operation knob 37 serving as a rotation operation input unit. That is, in a relative rotatable state, the sheath unit 5 and the probe unit 3 are rotatable relative to each other in directions around the longitudinal axis.

FIG. 30 is a diagram showing a connected state of the rotary operation knob 37, the sheath unit 5, and the connecting cylindrical member 45 in the second treatment mode. As shown in FIG. 30 , in the second treatment mode, the cylindrical member 45 is connected so as to rotate the operation knob 37 and the movable cylindrical member 46 (the sheath unit 5 ) in a direction around the longitudinal axis from the first treatment mode. The state configuration after the rotation angle of approximately 90° is rotated. At this time, the probe unit 3 and the sheath unit 5 are in a state where relative rotation is restricted so that they cannot rotate relative to each other in the direction around the longitudinal axis.

In the second treatment mode and in a state where relative rotation is restricted, each rotation state switching lever 161A, 161B is located at the first operation position. At this time, like the first processing mode, the engaging pin 47A penetrates through the through hole 48A, and the engaging pin 47B penetrates through the through hole 48B. However, unlike the first processing mode, the engaging pin 47A is engaged with the engaging recessed portion 49C, and the engaging pin 47B is engaged with the engaging recessed portion 49D. Therefore, the connecting cylindrical member 45 is fixed to the rotary operation knob 37 in a state rotated by a rotation angle of approximately 90° in the direction around the longitudinal axis relative to the rotary operation knob 37 and the sheath unit 5 from the first treatment mode.

The probe main body 21 (probe unit 3 ) is fixed to the connecting cylindrical member 45 via the elastic member 51 in two states of being restricted from relative rotation and being capable of relative rotation. Therefore, in the second treatment mode, the probe unit 3 is in a state after it has been rotated approximately 90° in the direction around the longitudinal axis with respect to the rotation operation knob 37 and the sheath unit 5 from the first treatment mode. Thus, in the second treatment mode, the probe conductive part 23 is arranged in a state after being rotated by a rotation angle of approximately 90° relative to the jaw 42 and the sheath unit 5 in the direction around the longitudinal axis from the first treatment mode (refer to Figure 24 and Figure 25).

As described above, the rotation state switching levers (rotation state switching parts) 161A, 161B and the rotation operation knob (rotation operation input part) 37 serve as inter-electrode distance changing means for making the second distance D2 smaller than the first distance D1, wherein , the first distance D1 refers to the distance between the first electrode part 25 and the second electrode part 105 in the first treatment mode, and the second distance D2 refers to the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode. distance between sections 105. In addition, as described above, the angular positions of the probe unit 3 and the sheath unit 5 relative to each other in the direction around the longitudinal axis in the relative rotatable state can be changed by operating the rotary operation knob 37, or The change of the above-mentioned angular position can be realized by directly rotating the probe main body 21 (probe unit 3 ) in a direction around the longitudinal axis.

Next, the action of the grasping treatment device 1 of this embodiment will be described. When the treatment is performed in the first treatment mode using the grip treatment device 1 , the rotation state switching levers 161A and 161B as the rotation state switching section are located at the first operation position. Furthermore, the engaging pin 47A is engaged with the engaging recessed portion 49A, and the engaging pin 47B is engaged with the engaging recessed portion 49B. As a result, the probe unit 3 and the sheath unit 5 are in a state where relative rotation is restricted so that they cannot rotate relative to each other in the direction around the longitudinal axis. In this state, the movable handle 33 is closed relative to the fixed handle 32 . As a result, as described in the first embodiment, the jaw 42 closes the probe conductive portion 23 of the probe main body 21 (probe unit 3 ), thereby grasping objects such as blood vessels between the jaw 42 and the probe conductive portion. Between 23.

Then, the operator presses the treatment mode input button 57A serving as the treatment mode input unit, thereby bringing the switch unit 58A into a closed state. As a result, the ultrasonic generating current is output from the ultrasonic generating current supply unit 8 , and the high-frequency current is output from the high-frequency current supply unit 9 . Then, ultrasonic vibration is generated by the ultrasonic vibrator 12 , and the ultrasonic vibration is transmitted to the probe conductive portion 23 (tip portion of the probe unit 3 ). The frictional heat generated by the ultrasonic vibration of the probe unit 3 coagulates or cuts the grasped object grasped between the probe conductive portion 23 (tip portion of the probe body 21 ) and the jaw 42 .

In addition, the high-frequency current output from the high-frequency current supply unit 9 is transmitted to the probe conductive unit 23 via the electrical signal line 17 , the ultrasonic vibrator 12 , the horn 15 , and the probe main body 21 (probe unit 3 ). When the high-frequency current is transmitted, the probe conductive part 23 functions as the first electrode part 25 having the first potential E1. In addition, the high-frequency current is transmitted from the high-frequency current supply part 9 to the jaw conductive part 93 via the electrical signal line 69 , the fourth conductive part 63D, the movable cylindrical member 46 , the inner tube 77 , and the jaw 42 . When the high-frequency current is transmitted, the jaw conductive part 93 functions as the second electrode part 105 having a second potential E2 different in magnitude from the first potential E1 . Since the probe conductive part 23 (the first electrode part 25) has the first potential E1, and the jaw conductive part 93 (the second electrode part 105) has the second potential E2, therefore, it is possible to control the probe conductive part 23 and the jaw part. The objects to be controlled between 42 are fed with high-frequency current. Thereby, the object to be grasped such as the living tissue T can be denatured, and coagulation of the object to be grasped can be promoted.

When performing treatment in the second treatment mode after performing treatment in the first treatment mode, the operator moves the rotation state switching levers 161A, 161B as the rotation state switching unit to the second operation position. Thereby, the engagement between the engaging pin 47A and the engaging recessed portion 49A is released, and the engagement between the engaging pin 47B and the engaging recessed portion 49B is released. Therefore, the probe unit 3 and the sheath unit 5 are in a relative rotatable state where they are rotatable relative to each other in the direction around the longitudinal axis.

In this state, the operation of rotating the sheath unit 5 and the jaw 42 relative to the probe unit 3 in a direction around the longitudinal axis is performed by using the rotation operation knob 37 as a rotation operation input unit. Furthermore, instead of the operation of rotating the operation knob 37 , the operation of directly rotating the probe unit 3 relative to the sheath unit 5 and the jaw 42 may be performed. Then, the probe unit 3 is placed at an angular position after being rotated approximately 90° in the direction around the longitudinal axis with respect to the rotational operation knob 37 and the sheath unit 5 from the first treatment mode.

Then, the rotation state switching levers 161A and 161B are moved to the first operation position. At this time, the connection cylindrical member 45 is rotated by a rotation angle of approximately 90° in the direction around the longitudinal axis with respect to the rotation operation knob 37 from the first treatment mode. Therefore, the engaging pin 47A is engaged with the engaging recessed portion 49C, and the engaging pin 47B is engaged with the engaging recessed portion 49D. As a result, the probe unit 3 and the sheath unit 5 are in a state where relative rotation is restricted so that they cannot rotate relative to each other in the direction around the longitudinal axis.

Then, processing in the second processing mode is performed. When performing treatment in the second treatment mode, first, the movable handle 33 is closed relative to the fixed handle 32 . Thereby, as described in the above-mentioned first embodiment, the jaw 42 performs a closing action relative to the probe conductive portion 23 of the probe main body 21 (probe unit 3 ), thereby grasping a grasping object such as a blood vessel between the probe conductive portion 23 and the jaw. between the conductive parts 93 .

Then, the operator presses the treatment mode input button 57B serving as the treatment mode input unit to bring the switch unit 58B into the closed state. Thus, a high-frequency current is output from the high-frequency current supply unit 9 . At this time, no current is output from the ultrasonic generation current supply unit 8 . The high-frequency current output from the high-frequency current supply unit 9 is transmitted to the probe conductive unit 23 via the electric signal line 17 , the ultrasonic vibrator 12 , the horn 15 , and the probe main body 21 (probe unit 3 ). The probe conductive part 23 can be made to function as the 1st electrode part 25 which has the 1st electric potential E1 by being transmitted with a high-frequency electric current.

In addition, the high-frequency current is transmitted from the high-frequency current supply part 9 to the jaw conductive part 93 via the electrical signal line 69 , the fourth conductive part 63D, the movable cylindrical member 46 , the inner tube 77 , and the jaw 42 . When the high-frequency current is transmitted, the jaw conductive portion 93 functions as the second electrode portion 105 having a second potential E2 having a magnitude different from the first potential E1. In the second treatment mode, ultrasonic vibration is not transmitted to the probe conductive part 23 (the tip part of the probe unit 3 ), but only high-frequency current is transmitted to the first electrode part 25 and the second electrode part 105 . Since the first electrode part 25 (probe conductive part 23) has a first potential E1, and the second electrode part 105 (jaw part conductive part 93) has a second potential E2, therefore, it is possible to control the probe conductive part 23 and the jaw part. The objects to be controlled between 42 are fed with high-frequency current. Thereby, the object to be grasped such as the living tissue T can be denatured, and the object to be grasped can be coagulated.

In the second treatment mode, the probe conductive part 23 is arranged in a state rotated by a rotation angle of approximately 90° relative to the jaw 42 and the sheath unit 5 in the direction around the longitudinal axis from the first treatment mode. Therefore, the second electrode opposing surface 155 (the second probe obliquely opposing surface 152B and the third probe obliquely opposing surface 152C) of the first electrode part 25 is connected to the jaw conductive part 93 (jaw obliquely opposing surface 98A) of the second electrode part 105. , 98B) is the second distance D2. The second distance D2 is smaller than the first distance D1. That is, the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode is smaller than that in the first treatment mode. Since the distance between the first electrode part 25 and the second electrode part 105 becomes smaller, compared with the first treatment mode, in the second treatment mode, the use of high-frequency current to make the living tissue T (holding object) is facilitated. degeneration. Therefore, the performance of coagulating the grasped object by the high-frequency current is improved, and therefore, even in the second treatment mode in which ultrasonic vibration is not used, the degradation of the coagulation performance of the grasped object is prevented. Thereby, even in the second treatment mode that does not use ultrasonic vibrations, the grasping object (living tissue) is stably sealed.

Therefore, the grasping treatment device 1 configured as described above exhibits the following effects. That is, in the second treatment mode of holding the treatment device 1, the probe conductive part 23 is rotated by a rotation angle of approximately 90° relative to the jaw 42 and the sheath unit 5 in the direction around the longitudinal axis from the first treatment mode. state configuration. Therefore, the second electrode opposing surface 155 (the second probe obliquely opposing surface 152B and the third probe obliquely opposing surface 152C) of the first electrode part 25 is connected to the jaw conductive part 93 (jaw obliquely opposing surface 98A) of the second electrode part 105. , 98B) is the second distance D2. The second distance D2 is smaller than the first distance D1. That is, the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode is smaller than that in the first treatment mode. Since the distance between the first electrode part 25 and the second electrode part 105 becomes smaller, compared with the first treatment mode, in the second treatment mode, the use of high-frequency current to make the living tissue T (holding object) is facilitated. degeneration. Therefore, the performance of coagulating the grasped object by high-frequency current is improved, and therefore, even in the second treatment mode that does not use ultrasonic vibrations, it is possible to prevent the degradation of the coagulation performance of the grasped object. Accordingly, even in the second treatment mode that does not use ultrasonic vibrations, it is possible to stably seal the gripping object (living tissue).

Modification of the third embodiment

In addition, in the second treatment mode of the third embodiment, the probe conductive part 23 is rotated by a rotation angle of approximately 90° relative to the jaw 42 and the sheath unit 5 in the direction around the longitudinal axis from the first treatment mode. state configuration, but is not limited to it. For example, as a modified example, as shown in FIG. 31 and FIG. 32 , in the second treatment mode, the probe conductive part 23 may be oriented in a direction around the longitudinal axis relative to the jaw 42 and the sheath unit 5 in the first treatment mode. The state configuration after rotating by a rotation angle of approximately 180°.

In this modified example, the probe conductive part 23 has a first probe vertically facing surface 162A parallel to the jaw vertically facing surface 97 in the first treatment mode. In the first treatment mode, the jaw vertically facing surface (abutting portion) 97 can be brought into contact with the first probe vertically facing surface 162A. In the width direction perpendicular to the longitudinal axis C and the opening and closing direction of the jaw 42 , a first probe obliquely opposing surface 163A and a second probe obliquely opposing surface 163B are provided on both sides of the first probe vertically opposing surface 162A. In the first treatment mode, the first probe obliquely facing surface 163A is substantially parallel to the jaw obliquely facing surface 98A, and is opposed to the jaw obliquely facing surface 98A. In addition, the second probe obliquely facing surface 163B is substantially parallel to the jaw obliquely facing surface 98B, and is opposed to the jaw obliquely facing surface 98B. That is, the first electrode facing surface 153 facing the jaw conductive portion 93 in the first treatment mode is formed by the first probe obliquely facing surface 163A and the second probe obliquely facing surface 163B.

In the first treatment mode, the first electrode facing surface 153 (the first probe obliquely facing surface 163A and the second probe obliquely facing surface 163B) of the first electrode part 25 is in contact with the jaw conductive part 93 (forceps) of the second electrode part 105. The distance between the component inclined facing surfaces 98A, 98B) is the first distance D1. Accordingly, the first electrode-facing surface 153 faces the jaw conductive portion 93 at a distance D1 from the jaw conductive portion 93 .

The probe conductive portion 23 has a second probe vertically facing surface 162B parallel to the jaw vertically facing surface 97 in the second treatment mode. The second probe vertically facing surface 162B is disposed at an angle of approximately 180° from the first probe vertically facing surface 162A in the direction around the longitudinal axis. In the second treatment mode, the jaw vertically facing surface (abutting portion) 97 can be brought into contact with the second probe vertically facing surface 162B.

In the width direction perpendicular to the longitudinal axis C and the opening and closing direction of the jaw 42 , a third probe obliquely opposing surface 163C and a fourth probe obliquely opposing surface 163D are provided on both sides of the second probe vertically opposing surface 162B. In the second treatment mode, the third probe obliquely facing surface 163C is substantially parallel to the jaw obliquely facing surface 98A, and is opposed to the jaw obliquely facing surface 98A. In addition, the fourth probe obliquely facing surface 163D is substantially parallel to the jaw obliquely facing surface 98B, and is opposed to the jaw obliquely facing surface 98B. That is, the second electrode facing surface 155 facing the jaw conductive part 93 in the second treatment mode is formed by the third probe obliquely facing surface 163C and the fourth probe obliquely facing surface 163D. The third probe obliquely facing surface 163C is disposed at an angle of approximately 180° from the first probe obliquely facing surface 163A in the direction around the longitudinal axis. In addition, the fourth probe obliquely facing surface 163D is disposed at an angle of approximately 180° from the second probe obliquely facing surface 163B in the direction around the longitudinal axis. Therefore, the second electrode-facing surface 155 is disposed at an angle of approximately 180° from the first electrode-facing surface 153 in the direction around the longitudinal axis.

In the second treatment mode, the second electrode facing surface 155 (the third probe obliquely facing surface 163C and the fourth probe obliquely facing surface 163D) of the first electrode part 25 is in contact with the jaw conductive part 93 (forceps) of the second electrode part 105. The distance between member inclined facing surfaces 98A, 98B) is a second distance D2 smaller than the first distance D1. Therefore, the second electrode-facing surface 155 faces the jaw conductive portion 93 at a distance of the second distance D2 that is smaller than the first distance D1 from the jaw conductive portion 93 .

As mentioned above, according to the modified example, the distance between the first electrode part 25 and the second electrode part 105 in the second treatment mode is smaller than the distance between the first electrode part 25 and the second electrode part 105 in the first treatment mode. The configuration of the distance is not limited to the third embodiment. That is, it is sufficient as long as the probe conductive part 23 has a first electrode-facing surface 153 and a second electrode-facing surface 155, and the first electrode-facing surface 153 is spaced apart from the jaw conductive part 93 by a second in the first treatment mode. 1. The state of the distance D1 faces the jaw conductive portion 93, and the second electrode-facing surface 155 is provided away from the first electrode-facing surface 153 in the direction around the longitudinal axis. In this case, the second electrode facing surface 155 faces the jaw conductive part 93 in a state of being separated from the jaw conductive part 93 by the second distance D2 smaller than the first distance D1 in the second treatment mode. Furthermore, the states of the sheath unit 5 and the probe unit 3 can be switched between a state in which relative rotation is restricted and a state in which relative rotation is possible by using the rotation state switching section (rotation state switching levers 161A, 161B), wherein The state of restricting relative rotation means that the sheath unit 5 and the probe unit 3 cannot rotate relative to each other in the direction around the longitudinal axis, and the state of being able to relatively rotate means that the sheath unit 5 and the probe unit 3 can rotate relative to each other. The state in which the direction is rotated about the direction of the length axis.

Other modifications

In addition, in the first embodiment, the movable handle 33 is located on the distal side of the fixed handle 32 , but the present invention is not limited thereto. For example, as a modified example of the above-described embodiment, as shown in FIG. 33 , the movable handle 33 may be located on the proximal side of the fixed handle 32 . Also in this modified example, the movable handle 33 can be opened and closed substantially parallel to the longitudinal axis C with respect to the fixed handle 32 as in the above-mentioned embodiment. Further, the movable cylindrical member 46 and the inner tube 77 of the sheath main body 41 move along the longitudinal axis C relative to the handle unit 4 and the probe unit 3 in response to the opening and closing movement of the movable handle 33 . By moving the inner tube 77 along the longitudinal axis C, the jaw 42 performs an opening and closing operation with respect to the probe conductive portion 23 .

In addition, in the first treatment mode of the above-described embodiment, a high-frequency current is output from the high-frequency current supply unit 9 , and the high-frequency current is transmitted to the first electrode unit 25 and the second electrode unit 105 . However, in the first treatment mode, for example, the high-frequency current may not be output from the high-frequency current supply unit 9 and the high-frequency current may not be transmitted to the first electrode part 25 and the second electrode part 105 . That is, in the first treatment mode, it is only necessary that at least ultrasonic vibrations are generated by the ultrasonic vibrator 12 and at least the ultrasonic vibrations are transmitted to the probe conductive portion 23 . As a result, coagulation and incision of the grasped object such as the living tissue T are performed in the first treatment mode.

From the above, it can be seen that the first electrode part 25 may be provided in at least any one of the probe conductive part 23 between the jaw 42 and the probe conductive part 23 in the opening and closing direction of the jaw 42 . In this case, the first electrode portion 25 has the first potential E1 in a state where a high-frequency current is transmitted through the probe unit 3 . Furthermore, the second electrode portion 105 may be provided in at least any one of the jaw conductive portion 93 and between the jaw 42 and the first electrode portion 25 in the opening and closing direction of the jaw 42 . In this case, the second electrode portion 105 has a second potential E2 having a magnitude different from the first potential E1 in a state where a high-frequency current is transmitted through the sheath unit 5 . Moreover, it is only necessary to provide an inter-electrode distance changing means for making the second distance D2 smaller than the first distance D1, wherein the first distance D1 refers to at least the distance in the first treatment mode in which the ultrasonic vibration is transmitted to the probe conductive part 23. , the distance between the first electrode part 25 and the second electrode part 105, the second distance D2 refers to the second treatment mode in which only the high-frequency current is transmitted to the first electrode part 25 and the second electrode part 105, the second 1 is the distance between the electrode portion 25 and the second electrode portion 105 . In the first embodiment described above, the inter-electrode distance changing unit has the movement operation lever 83 as the movement operation input unit. In addition, in the second embodiment, the inter-electrode distance changing means has a movement operation button 133 as a movement operation input unit. In the third embodiment, the inter-electrode distance changing means includes rotation state switching levers 161A and 161B as rotation state switching parts, and a rotation operation knob 37 as a rotation operation input part.

Reference example

Next, a reference example of the present invention will be described with reference to FIGS. 34 to 36 . In addition, the same code|symbol is attached|subjected to the same part as 1st Embodiment, and description is abbreviate|omitted.

FIG. 34 is a diagram showing the configuration of the distal end portion of the probe unit 3 and the jaw 42 . As shown in FIG. 34 , in this reference example, the probe conductive portion 23 is provided at the distal end portion of the probe main body 21 (probe unit 23 ) as in the first embodiment. By transmitting high-frequency current through the probe unit 3 , the probe conductive portion 23 functions as the first electrode portion 25 having the first potential E1 .

Similar to the first embodiment, the jaw 42 is provided with a jaw main body 91 , a jaw conductive portion 93 , and a pad member (insulating contact member) 95 . Furthermore, the jaw 42 has a first treatment area X1 and a second treatment area X2 provided on the proximal side of the first treatment area X1. That is, the second treatment region X2 is located at a position separated from the first treatment region in the direction parallel to the longitudinal axis C. In the first treatment area X1, the treatment in the above-mentioned first treatment mode is performed, and in the second treatment area X2, the treatment in the above-mentioned second treatment mode is performed.

Fig. 35 is a sectional view taken along line 35-35 in Fig. 34 . As shown in FIG. 35 , like the first embodiment, the probe conductive portion 23 has a probe vertically facing surface 102 and probe obliquely facing surfaces 103A, 103B. In the first treatment region X1, a first jaw vertically facing surface (contact portion) 171 is formed by the pad member 95 . The first jaw vertically facing surface 171 is perpendicular to the opening and closing direction of the jaw 42 and parallel to the probe vertically facing surface 102 . When the jaw 42 is closed with respect to the probe conductive part 23 , the first jaw vertically facing surface (abutting part) 171 can abut against the probe vertically facing surface 102 (probe conductive part 23 ).

In the direction perpendicular to the longitudinal axis C and to the opening and closing direction of the jaw 42 , that is, in the width direction, jaw inclined opposing surfaces 172A, 172A, 172B. The jaw obliquely facing surface 172A is provided substantially parallel to the probe obliquely facing surface 103A, and is separated from the probe obliquely facing surface 103A by the first distance D1. In addition, the jaw obliquely facing surface 172B is provided substantially parallel to the probe obliquely opposing surface 103B, and is separated from the probe obliquely opposing surface 103B by the first distance D1. Therefore, in the first treatment area X1, the probe conductive part 23 (probe obliquely facing surfaces 103A, 103B) of the first electrode part 25 and the jaw conductive part 93 (jaw obliquely facing surfaces 172A, 172B) of the second electrode part 105 ) are separated by a first distance D1.

Fig. 36 is a sectional view taken along line 36-36 in Fig. 34 . As shown in FIG. 36, the pad member 95 is not provided in the 2nd processing area|region X2. In addition, jaw inclined facing surfaces 172A and 172B are formed by the jaw conductive portion 93 in the second treatment region X2 . The positional relationship of the inclined facing surfaces 172A and 172B of the jaw with respect to the probe conductive portion 23 is the same as that in the first treatment region X1.

In the second treatment region X2 , the second jaw vertically facing surface 173 is formed by the jaw conductive portion 93 . The jaw obliquely facing surfaces 172A and 172B are located on both sides of the second jaw vertically facing surface 173 in the width direction, which is a direction perpendicular to the longitudinal axis C and the opening and closing direction of the jaw 42 . The second jaw vertically facing surface 173 is perpendicular to the opening and closing direction of the jaw 42 and parallel to the probe vertically facing surface 102 . The second jaw vertically facing surface 173 is arranged at a distance from the probe vertically facing surface 102 by a second distance D2 smaller than the first distance D1. Therefore, in the first treatment area X1, the gap between the probe conductive portion 23 (probe vertically facing surface 102) of the first electrode portion 25 and the jaw conductive portion 93 (the second jaw vertically facing surface 173) of the second electrode portion 105 There is a second distance D2 smaller than the first distance D1 between them.

The treatment in the above-mentioned first treatment mode is performed by holding the grasped object between the first treatment region X1 of the jaw 42 and the probe conductive part 23 . In the first treatment region X1 , the first jaw vertically facing surface 171 is formed by the spacer member 95 . Therefore, the distance between the probe conductive part 23 (probe obliquely facing surfaces 103A, 103B) of the first electrode part 25 and the jaw conductive part 93 (jaw obliquely facing surfaces 172A, 172B) of the second electrode part 105 is the first distance D1. The first distance D1 is sufficiently large. Therefore, even in the state where the probe main body 21 (probe unit 3) is ultrasonically vibrating, the first electrode part 25 (probe conductive part 23) and the second electrode part 105 (jaw conductive part 93) are effectively prevented. touch. Thus, failure of the grasping device 1 due to a short circuit can be effectively prevented.

In addition, in the first treatment mode, the probe main body 21 vibrates ultrasonically. Therefore, the pad member 95 capable of coming into contact with the probe conductive portion 23 in the state where the jaw 42 is closed relative to the probe conductive portion 23 is worn due to the treatment in the first treatment mode. As described above, in the first treatment region X1, the first distance D1 between the first electrode part 25 and the second electrode part 105 is relatively large. Therefore, even in the case where the pad member 95 is worn due to the treatment in the first treatment mode, from the beginning of using the grasping treatment device 1 until the probe conductive part 23 (first electrode part 25) and the jaw conductive part 93 (the second electrode portion 105 ) also has a longer elapsed time until it comes into contact with each other. Therefore, the life of the gripping treatment device 1 becomes longer.

The treatment in the above-mentioned second treatment mode is performed by holding the grasped object between the second treatment region X2 of the jaw 42 and the probe conductive part 23 . In the second treatment region X2 , the pad member 95 is not provided, and the second jaw vertically facing surface 173 is formed by the jaw conductive portion 93 . Therefore, the distance between the probe conductive portion 23 (probe vertically facing surface 102) of the first electrode portion 25 and the jaw conductive portion 93 (the second jaw vertically facing surface 173) of the second electrode portion 105 is the second distance D2 . The second distance D2 is smaller than the first distance D1. That is, the distance between the first electrode part 25 and the second electrode part 105 in the second treatment region X2 is smaller than that in the first treatment region X1. Since the distance between the first electrode part 25 and the second electrode part 105 becomes smaller, compared with the first treatment region X1, in the second treatment region X2, the use of high-frequency current to make the living tissue T (grasping object) degeneration. Therefore, the performance of coagulating the grasped object by the high-frequency current is improved, and therefore, even in the second treatment mode in which ultrasonic vibration is not used, the degradation of the coagulation performance of the grasped object is prevented. Accordingly, even in the second treatment mode that does not use ultrasonic vibrations, by performing treatment in the second treatment region X2, it is possible to stably seal the grasped object (living tissue).

In addition, in the second treatment area X2 , the probe vertically facing surface 102 of the probe conductive portion 23 is perpendicular to the opening and closing direction of the jaw 42 . In addition, the second jaw vertically facing surface 173 of the jaw conductive part is parallel to the probe vertically facing surface 102 and faces the probe vertically facing surface 102 . Since the probe vertically opposite surface 102 and the second jaw vertically opposite surface 173 are perpendicular to the opening and closing direction of the jaw 42, the grip is held between the jaw conductive part 93 (the second electrode part 105) and the probe conductive part 23 (the second electrode part 105). The gripping force of the gripping object between the 1 electrode parts 25) becomes larger. By increasing the gripping force, the performance of coagulating the gripped object with the high-frequency current is further improved. Thereby, it is possible to more stably seal the grasping target (living tissue).

As mentioned above, although embodiment of this invention was described, this invention is not limited to the said embodiment, Of course, various deformation|transformation is possible in the range which does not deviate from the summary of this invention.

The following content is a description of other technical features of the present invention.

appendix

Appendix 1

A handling device comprising:

The probe unit is extended along the length axis and can transmit ultrasonic vibration from the base end direction to the top end direction;

A sheath unit, which penetrates the probe unit and is electrically insulated from the probe unit;

a probe conductive part provided at the distal end of the probe unit, the probe conductive part functions as a first electrode part having a first potential in a state where a high-frequency current is transmitted through the probe unit; and

The jaw is mounted on the tip end of the sheath unit in a manner that can be opened and closed relative to the conductive portion of the probe, and has an abutting portion formed of an insulating material. In the state where the conductive part is closed, the abutting part can be in contact with the above-mentioned conductive part of the probe; and

The jaw conductive part functions as a second electrode part having a second potential different in magnitude from the first potential in a state where a high-frequency current is transmitted through the sheath unit,

The jaw parts mentioned above include:

A first treatment area, in which the abutment portion is provided, in which there is a first distance between the conductive portion of the jaw and the conductive portion of the probe, in the first treatment area performing treatment in a first treatment mode, wherein the first treatment mode refers to a mode in which at least the ultrasonic vibrations are transmitted to the conductive portion of the probe; and

A second treatment region in which the abutment portion is not provided, and in which there is a second distance between the conductive portion of the jaw and the conductive portion of the probe that is smaller than the first distance , the second treatment area is located at a position apart from the first treatment area in a direction parallel to the above-mentioned longitudinal axis, and the treatment in the second treatment mode is performed in the second treatment area, wherein the second treatment mode refers to Only the mode in which the high-frequency current is transmitted to the probe conductive portion and the jaw conductive portion.

Appendix 2

The handling device according to appendix 1, wherein,

The conductive part of the probe has a vertically opposite surface of the probe, and the vertically opposed surface of the probe is arranged perpendicular to the opening and closing direction of the jaw, and is opposite to the jaw,

The abutting portion has a first jaw vertically opposing surface, the first jaw vertically opposing surface can be in contact with the probe vertically opposing surface in the first treatment area, and is parallel to the probe vertically opposing surface,

The conductive portion of the jaw has a second jaw vertically facing surface parallel to the probe vertically facing surface in the second treatment region and separated from the probe vertically facing surface by the second distance.

Appendix 3

A handling device, wherein the handling device includes:

a probe body extending along the length axis and capable of transmitting ultrasonic vibrations;

The conductive part of the probe, which is provided at the tip of the probe body, has a first potential in a state where a high-frequency current is introduced;

a jaw member capable of opening and closing relative to the probe body;

The conductive portion of the jaw, which is provided on the jaw, has a second potential different in magnitude from the first potential in a state where the high-frequency current is transmitted, and is arranged opposite to the conductive portion of the probe;

The first electrode-facing surface is provided on the outer surface of the probe conductive part, and in the first state where the first electrode-facing surface is arranged opposite to the jaw conductive part, the distance from the jaw conductive part to the probe conductive part The distance is the first distance;

A second electrode-facing surface provided on a portion of the outer surface of the probe conductive portion that is different from the first electrode-facing surface, in a second state where the second electrode-facing surface is arranged opposite to the jaw conductive portion , the distance from the conductive portion of the jaw to the conductive portion of the probe is a second distance smaller than the first distance; and

An operation input unit switches between the first state in which the first electrode facing surface and the jaw conductive portion are opposed to each other, and the second state in which the second electrode facing surface and the jaw conductive portion are opposed to each other.

Appendix 4

The handling device according to appendix 3, wherein,

The operation input unit performs the switching between the first state and the second state by rotating the probe conductive portion relative to the jaw conductive portion in a direction around the longitudinal axis.

Appendix 5

The handling device according to appendix 3, wherein,

The operation input unit switches the probe conductive part to the first state in the first treatment mode in which at least the ultrasonic vibration is transmitted to the probe conductive part, and switches the probe conductive part to the first state when only the high-frequency current is transmitted to the probe conductive part and the forceps. In the second processing mode of the component conductive portion, the probe conductive portion is switched to the second state.

Appendix 6

The handling device according to appendix 3, wherein,

The grasping treatment device further includes a rotation state switching unit configured to switch between a state of restricted relative rotation in which the probe conductive portion and the jaw conductive portion cannot rotate relative to each other in a direction around the longitudinal axis, and the above-mentioned The probe conductive part and the jaw conductive part can switch between relative rotatable states in which they can rotate relative to each other in a direction around the longitudinal axis.

Appendix 7

The handling device according to appendix 6, wherein,

The operation input unit inputs an operation to integrally rotate the jaw and the probe body in a direction around the longitudinal axis in the state where the relative rotation is restricted.

Appendix 8

The handling device according to appendix 6, wherein,

In the relatively rotatable state, the jaw and the probe main body are rotated relative to each other in a direction around the longitudinal axis in accordance with the switching by the operation input unit.

Appendix 9

The handling device according to appendix 6, wherein,

The handling device further includes a sheath main body, the sheath main body is penetrated by the probe main body, and is electrically insulated from the probe main body,

The jaws are mounted on the sheath body,

The rotation state switching unit performs the switching between the relative rotation-restricted state and the relative rotation-capable state by switching the connection state between the sheath body and the probe body.

Appendix 10

The handling device according to appendix 3, wherein,

The above-mentioned jaw has an abutting portion, which is formed of an insulating material and can be abutted against the conductive portion of the probe,

In a state where the contact portion is in contact with the probe conductive portion, there is a gap between the jaw conductive portion and the probe conductive portion.

Claims (8)

1. a holding blood processor, wherein,

This holding blood processor comprises:

Probe body, it is extended along length axes, and can transmit ultrasound wave vibration;

Probe conductive part, it is located at the top ends of above-mentioned probe body, and under the state being passed into high frequency electric, have the 1st current potential;

Pincers parts, it can relative to above-mentioned probe body opening and closing;

Pincers components conductive portion, it has the 2nd current potential varied in size with above-mentioned 1st current potential under the state being passed into above-mentioned high frequency electric, and is oppositely disposed with above-mentioned probe conductive part in above-mentioned pincers parts;

1st electrode apparent surface, it is located at the outer surface of above-mentioned probe conductive part, and under the 1st state that above-mentioned 1st electrode apparent surface and above-mentioned pincers components conductive portion are oppositely disposed, the distance from above-mentioned pincers components conductive portion to above-mentioned probe conductive part is the 1st distance;

2nd electrode apparent surface, that it is located at the above-mentioned outer surface of above-mentioned probe conductive part, different from above-mentioned 1st electrode apparent surface positions, under the 2nd state that above-mentioned 2nd electrode apparent surface and above-mentioned pincers components conductive portion are oppositely disposed, the distance from above-mentioned pincers components conductive portion to above-mentioned probe conductive part is apart from the 2nd little distance than the 1st;

Operation inputting part, it switches by making above-mentioned probe conductive part move between above-mentioned 2nd state that above-mentioned 1st state and above-mentioned 2nd electrode apparent surface that are oppositely disposed above-mentioned 1st electrode apparent surface and above-mentioned pincers components conductive portion and above-mentioned pincers components conductive portion be oppositely disposed relative to above-mentioned pincers components conductive portion.

2. holding blood processor according to claim 1, wherein,

Aforesaid operations input part carries out above-mentioned switching by making above-mentioned probe conductive part rotate to the direction around length axes relative to above-mentioned pincers components conductive portion between above-mentioned 1st state and above-mentioned 2nd state.

3. holding blood processor according to claim 1, wherein,

Above-mentioned probe conductive part is switched to above-mentioned 1st state vibrate the 1st tupe being passed to above-mentioned probe conductive part at least above-mentioned ultrasound wave under by aforesaid operations input part, under being passed to the 2nd tupe in above-mentioned probe conductive part and above-mentioned pincers components conductive portion, above-mentioned probe conductive part is switched to above-mentioned 2nd state at only above-mentioned high frequency electric.

4. holding blood processor according to claim 1, wherein,

This holding blood processor also comprises rotation status switching part, this rotation status switching part be used for above-mentioned probe conductive part and above-mentioned pincers components conductive portion each other cannot relative to the state being limited relatively to rotate that direction is rotated around the direction of length axes and above-mentioned probe conductive part and above-mentioned pincers components conductive portion each other can relative to the state that can relatively rotate rotated around the direction of above-mentioned length axes direction between switch.

5. holding blood processor according to claim 4, wherein,

Under the above-mentioned state being limited rotation relatively, the input of aforesaid operations input part makes above-mentioned pincers parts and above-mentioned probe body integratedly to the operation that the direction around above-mentioned length axes rotates.

6. holding blood processor according to claim 4, wherein,

Under the above-mentioned state that can relatively rotate, above-mentioned pincers parts and above-mentioned probe body, according to the above-mentioned switching utilizing aforesaid operations input part to carry out, make toward each other in rotating the direction of direction around above-mentioned length axes.

7. holding blood processor according to claim 4, wherein,

This holding blood processor also comprises sheath body, and this sheath body runs through for above-mentioned probe body, and and electric insulation between above-mentioned probe body,

Above-mentioned pincers parts are installed on above-mentioned sheath body,

Above-mentioned rotation status switching part carries out the above-mentioned above-mentioned switching be limited between the relative state that rotates and the above-mentioned state that can relatively rotate by the connecting state switched between above-mentioned sheath body with above-mentioned probe body.

8. holding blood processor according to claim 1, wherein,

Above-mentioned pincers parts have abutting part, and this abutting part is formed by insulant, and can be connected to above-mentioned probe conductive part,

Under the state that above-mentioned abutting part is connected to above-mentioned probe conductive part, between above-mentioned pincers components conductive portion and above-mentioned probe conductive part, there is gap.